Active NPI
Debra Gregory Bayham, PA
- Physician Assistant
- Phoenix, AZ
National Provider Identifier
1346461803
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 2270
- Practice address
- 333 E Virginia Ave
220
Phoenix, AZ 85004-1206 - Phone
- (602) 258-9955
- Fax
- (602) 258-9933
- NPI assigned
- May 1, 2007
- Last updated
- Nov 5, 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 2270 | AZ | Primary |
Addresses
Primary practice location
333 E Virginia Ave
220
Phoenix, AZ 85004-1206
Mailing address
333 E Virginia Ave
220
Phoenix, AZ 85004-1206
Phone (602) 258-9955
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 596554 | Medicaid | AZ |
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2270 | AZ | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Center for Physical Medicine & Rehabilitation P C | Past | Accepting new patients | |
| Med 97 LLC | Past | Accepting new patients | |
| Grace Zlaket Matta MD LLC | Past | Accepting new patients | |
| Midtown Endocrine Associates PC | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/HHFIBA
- https://fhir4.healow.com/fhir/r4/JCGHBA
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Medicine & Rehabilitation Physician
- Phoenix, AZ
- NPI 1306959218
-
- Specialist
- Scottsdale, AZ
- NPI 1720284334
-
- Endocrinology, Diabetes & Metabolism Physician
- Phoenix, AZ
- NPI 1972896918
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288915200000",
"number": "1346461803",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "333 E VIRGINIA AVE",
"address_2": "220",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850041206",
"telephone_number": "602-258-9955",
"fax_number": "602-258-9933"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 E VIRGINIA AVE",
"address_2": "220",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850041206",
"telephone_number": "602-258-9955",
"fax_number": "602-258-9933"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAYHAM",
"first_name": "DEBRA",
"middle_name": "GREGORY",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-01",
"last_updated": "2010-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AZ",
"license": "2270",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "596554",
"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 5, 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.