Active NPI
Berdine S Bender, MD
- Internal Medicine Physician
- Spokane, WA
National Provider Identifier
1295790129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD00021075
- Practice address
- 546 N Jefferson LN
Spokane, WA 99201-7104 - Phone
- (509) 624-0111
- Fax
- (509) 227-7070
- NPI assigned
- Apr 20, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD00021075 | WA | Primary |
Addresses
Primary practice location
546 N Jefferson LN
Spokane, WA 99201-7104
Mailing address
PO Box 421
Liberty Lake, WA 99019-0421
Phone (509) 624-0111
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1148501 | Medicaid | WA | |
| 126573 | Other | WA | L & I |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 025209 | WA | MD | Ophthalmology Physician |
Interoperability endpoints
- bbender221364@wm.providencedirect.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1295790129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 421",
"city": "LIBERTY LAKE",
"state": "WA",
"postal_code": "990190421",
"telephone_number": "509-624-0111",
"fax_number": "509-227-7070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "546 N JEFFERSON LN",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992017104",
"telephone_number": "509-624-0111",
"fax_number": "509-227-7070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENDER",
"first_name": "BERDINE",
"middle_name": "S",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-20",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WA",
"license": "MD00021075",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1148501",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L & I",
"identifier": "126573",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Spokane, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.