Fred S. Markham, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

15168 Issued in AZ

Practice address

804 Ainsworth Dr
# 104
Prescott, AZ 86301-1624

Phone

(928) 778-1736

Fax

(928) 717-0786

NPI assigned

Apr 19, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• The Evangelical Lutheran Good Samaritan Society

  • Community Based Hospice Care Agency
  • Prescott, AZ
  • NPI 1326238874

  Contracted Managing Employee

  CMS ownership

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Fred S Markham MD PC

  • Internal Medicine Physician
  • Prescott, AZ
  • NPI 1073545240
  NPD Authorized official

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455580800000",
    "number": "1679538995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20490",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852770490",
            "telephone_number": "480-985-1093",
            "fax_number": "480-985-0468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 AINSWORTH DR",
            "address_2": "# 104",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011624",
            "telephone_number": "928-778-1736",
            "fax_number": "928-717-0786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKHAM",
        "first_name": "FRED",
        "middle_name": "S.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2016-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "15168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "242694",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ivory Morgan Marinakis, PA
• Kathryn Marion, COTA/L
• Mark D Fetter MD PC
• Chris Markey, P.T.
• Laura Anne Markey, PHYSICAL THERAPIST
• John R Markham, O D
• Scott Patrick Markham, D.O.
• Katie R Marolia, MS, OTR/L
• Shelley Marsh, CTRS
• Kelly L Marshall, FNP

• Internal Medicine Physician in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.