NPIMap

Individual provider Active NPI

Craig Wayne Bainbridge, M.D.

  • Internal Medicine Physician
  • Sioux City, IA
National Provider Identifier
1689750150
Registry record updated Aug 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
19741 Issued in IA
Practice address
2730 Pierce St
Suite 401
Sioux City, IA 51104-3796
Phone
(712) 255-8827
Fax
(712) 255-4862
NPI assigned
Oct 27, 2006
Last updated
Aug 11, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2009

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 19741 IA Primary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 19741 IA
Pulmonary Disease Physician 207RP1001X 19741 IA
Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X 19741 IA

Addresses

Primary practice location

2730 Pierce St
Suite 401
Sioux City, IA 51104-3796

Mailing address

2730 Pierce St
Suite 401
Sioux City, IA 51104-3796
Phone (712) 255-8827

Other identifiers 1

IdentifierTypeStateIssuer
P00724601OtherRR MEDICARE

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

LicenseStateTypeSpecialty
19741IAMDPreventive Medicine/Occupational Environmental Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spencer Municipal Hospital Current Accepting new patients
St Lukes Health Resources Past Accepting new patients
St Lukes Health Resources Internal Medicine Past Accepting new patients

Locations

1200 1st Ave E
Spencer, IA 51301
Phone (712) 264-6164

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249948800000",
    "number": "1689750150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2730 PIERCE ST",
            "address_2": "SUITE 401",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511043796",
            "telephone_number": "712-255-8827",
            "fax_number": "712-255-4862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2730 PIERCE ST",
            "address_2": "SUITE 401",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511043796",
            "telephone_number": "712-255-8827",
            "fax_number": "712-255-4862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAINBRIDGE",
        "first_name": "CRAIG",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2009-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "19741",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IA",
            "license": "19741",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IA",
            "license": "19741",
            "primary": false
        },
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "IA",
            "license": "19741",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00724601",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2009; 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.