Catherine Bomberger, MD, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

048188 Issued in GA

Legal business name

CATHERINE BOMBERGER, MD, LLC

Practice address

310 Hospital Dr
BLDG B, Suite 315
Macon, GA 31217-3895

Phone

(478) 464-1933

Fax

(478) 464-5094

NPI assigned

Oct 11, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Catherine Bomberger, MD

Title

Owner

Phone

(478) 464-1933

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1349913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349913600000",
    "number": "1194077339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 HOSPITAL DR",
            "address_2": "BLDG B, SUITE 315",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312173895",
            "telephone_number": "478-464-1933",
            "fax_number": "478-464-5094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 HOSPITAL DR",
            "address_2": "BLDG B, SUITE 315",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312173895",
            "telephone_number": "478-464-1933",
            "fax_number": "478-464-5094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATHERINE BOMBERGER, MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-11",
        "last_updated": "2012-10-11",
        "status": "A",
        "authorized_official_last_name": "BOMBERGER",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "478-464-1933",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "048188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00875476A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "11BDRTP",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Macon, GA
• Providers in Macon, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.