Active NPI
Alisha Dione Bogus, MD
- Anatomic Pathology & Clinical Pathology Physician
- Phoenix, AZ
National Provider Identifier
1114229572
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- R72127
- Practice address
- 350 W Thomas Rd
Attn: Academic Affairs
Phoenix, AZ 85013-4409 - Phone
- (602) 406-6129
- NPI assigned
- Nov 17, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | R72127 | AZ | Primary |
Addresses
Primary practice location
350 W Thomas Rd
Attn: Academic Affairs
Phoenix, AZ 85013-4409
Mailing address
350 W Thomas Rd
Attn: Academic Affairs
Phoenix, AZ 85013-4409
Phone (602) 406-6129
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| R72127 | Other | AZ | TRAINING PERMIT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R72127 | AZ | MD | Anatomic Pathology & Clinical Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1289952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289952000000",
"number": "1114229572",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "350 W THOMAS RD",
"address_2": "ATTN: ACADEMIC AFFAIRS",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850134409",
"telephone_number": "602-406-6129"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "350 W THOMAS RD",
"address_2": "ATTN: ACADEMIC AFFAIRS",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850134409",
"telephone_number": "602-406-6129"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOGUS",
"first_name": "ALISHA",
"middle_name": "DIONE",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-11-17",
"last_updated": "2010-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "AZ",
"license": "R72127",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRAINING PERMIT",
"identifier": "R72127",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.