NPIMap

Organization Active NPI

Bonham Emergency Medicine LLC

Doing business as GEMS Express Care

  • Family Medicine Physician
  • Belleville, IL
National Provider Identifier
1861654774
Registry record updated Jan 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BONHAM EMERGENCY MEDICINE LLC
Doing business as
GEMS Express Care
Practice address
76 Carlyle Plaza Dr
Belleville, IL 62221-6677
Phone
(618) 416-6560
Fax
(618) 416-6561
NPI assigned
Jul 1, 2008
Last updated
Jan 24, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2012

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

Authorized official

Name
Ruby F Yates, MD
Title
President
Phone
(618) 277-5974

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

76 Carlyle Plaza Dr
Belleville, IL 62221-6677

Mailing address

76 Carlyle Plaza Dr
Belleville, IL 62221-6677
Phone (618) 416-6560

Other names 1

  • GEMS Express Care Doing business as

National Provider Directory

National Provider Directory

Locations

76 Carlyle Plaza Dr
Belleville, IL 62221
Phone (618) 416-6560

Practitioners & affiliated clinicians

Practitioners 24

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1214870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327363200000",
    "number": "1861654774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 CARLYLE PLAZA DR",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622216677",
            "telephone_number": "618-416-6560",
            "fax_number": "618-416-6561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 CARLYLE PLAZA DR",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622216677",
            "telephone_number": "618-416-6560",
            "fax_number": "618-416-6561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BONHAM EMERGENCY MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-01",
        "last_updated": "2012-01-24",
        "status": "A",
        "authorized_official_last_name": "YATES",
        "authorized_official_first_name": "RUBY",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-277-5974",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GEMS Express Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Belleville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2012; 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.