Active NPI
Philipp Leo Bannwart, M.D.
- Family Medicine Physician
- Martinez, CA
National Provider Identifier
1194828491
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- A83871
- Practice address
- 2500 Alhambra Ave
Att Med Staff @ Ccrmc
Martinez, CA 94553-3156 - Phone
- (925) 370-5110
- NPI assigned
- Sep 6, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A83871 | CA | Primary |
Addresses
Primary practice location
2500 Alhambra Ave
Att Med Staff @ Ccrmc
Martinez, CA 94553-3156
Mailing address
2500 Alhambra Ave
Ccrmc, Att. Med Staff,
Martinez, CA 94553-3156
Phone (925) 370-5110
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412208000000",
"number": "1194828491",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 ALHAMBRA AVE",
"address_2": "CCRMC, ATT. MED STAFF,",
"city": "MARTINEZ",
"state": "CA",
"postal_code": "945533156",
"telephone_number": "925-370-5110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 ALHAMBRA AVE",
"address_2": "ATT MED STAFF @ CCRMC",
"city": "MARTINEZ",
"state": "CA",
"postal_code": "945533156",
"telephone_number": "925-370-5110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANNWART",
"first_name": "PHILIPP",
"middle_name": "LEO",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-06",
"last_updated": "2014-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "A83871",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Martinez, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.