Red Mountain Dermatology LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

RED MOUNTAIN DERMATOLOGY LLC

Practice address

1611 E Warner Rd Ste 5
Tempe, AZ 85284-4550

Phone

(480) 454-3561

NPI assigned

Feb 15, 2024

Last updated

Feb 15, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ryan Kirk BinghamNPI 1548779713

Title

Owner

Phone

(480) 625-4538

Specialties & licenses 1

Addresses

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ryan Kirk Bingham, PA

  • Medical Physician Assistant
  • Mesa, AZ
  • NPI 1548779713

  Dermatology

  NPD Authorized official
• Clark Richard Bingham, PA-C

  • Medical Physician Assistant
  • Mesa, AZ
  • NPI 1730775396

  Dermatology

  NPD
• Jeremy K Bingham, DO

  • Dermatology Physician
  • Mesa, AZ
  • NPI 1235391889
  NPD
• Adam Craig Turner

  • Medical Physician Assistant
  • Tempe, AZ
  • NPI 1447725189
  NPD

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

{
    "created_epoch": "1707955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707955200000",
    "number": "1437914819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2753 E BROADWAY RD # 101-436",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852041579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 E WARNER RD STE 5",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852844550",
            "telephone_number": "480-454-3561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED MOUNTAIN DERMATOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-15",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A",
        "authorized_official_last_name": "BINGHAM",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "KIRK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-625-4538"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; 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.