Organization Active NPI

Marvin E Bishop

  • Dermatology Physician
  • Winchester, KY
National Provider Identifier
1629048392
Registry record updated Sep 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
MARVIN E BISHOP
Practice address
218 S Maple St
Winchester, KY 40391
Phone
(859) 745-2861
Fax
(859) 745-1978
NPI assigned
Jan 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2010

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

Authorized official

Name
Marvin E Bishop, MD
Title
Physician
Phone
(859) 745-2861

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

218 S Maple St
Winchester, KY 40391

Mailing address

218 S Maple St
Winchester, KY 40391
Phone (859) 745-2861

Other identifiers 1

IdentifierTypeStateIssuer
65939746MedicaidKY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283904000000",
    "number": "1629048392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 S MAPLE ST",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "40391",
            "telephone_number": "859-745-2861",
            "fax_number": "859-745-1978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 S MAPLE ST",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "40391",
            "telephone_number": "859-745-2861",
            "fax_number": "859-745-1978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARVIN E BISHOP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-25",
        "last_updated": "2010-09-08",
        "status": "A",
        "authorized_official_last_name": "BISHOP",
        "authorized_official_first_name": "MARVIN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "859-745-2861",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65939746",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.

Verify at the official NPI Registry.