NPIMap

Individual provider Active NPI

Brad Robert Bingham, NP

  • Adult Health Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1861405425
Registry record updated Dec 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
0991260 Issued in CO
Practice address
2350 International Cir
Colorado Springs, CO 80910-3139
Phone
(719) 475-5065
Fax
(719) 475-5797
NPI assigned
Aug 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 0991260 CO Primary
Chiropractor 111N00000X 3190 CO

Addresses

Primary practice location

2350 International Cir
Colorado Springs, CO 80910-3139

Mailing address

2350 International Cir
Colorado Springs, CO 80910-3139
Phone (719) 475-5065

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140926000153 CO Practitioner - Nurse Practitioner 0749400711 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Agewell Medical Associates PCGroup PAC ID 8527164466, 6 clinicians

Practice addresses (Care Compare)

2350 International Cir
Colorado Springs, CO 80910-3139
Phone (719) 475-5065

Hospital & facility affiliations

  • Uch-Memorial Health System Hospital, Colorado Springs, CO, CCN 060022
  • Uchealth Pikes Peak Regional Hospital Hospital, Woodland Park, CO, CCN 061326
  • Centura Health-Penrose St Francis Health Services Hospital, Colorado Springs, CO, CCN 060031

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3190COMDChiropractor
0991260COMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Agewell Medical Associates, PC CurrentSince Aug 1, 2014 Accepting new patients

Locations

2350 International Cir
Colorado Springs, CO 80910
Phone (719) 475-5065

Organizations & group practices 1

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.

Hospital & facility affiliations 21

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417651200000",
    "number": "1861405425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 INTERNATIONAL CIR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809103139",
            "telephone_number": "719-475-5065",
            "fax_number": "719-475-5797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 INTERNATIONAL CIR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809103139",
            "telephone_number": "719-475-5065",
            "fax_number": "719-475-5797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BINGHAM",
        "first_name": "BRAD",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2014-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CO",
            "license": "0991260",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "3190",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.