Bertram Allen Flaxman, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

RI4029 Issued in RI

Practice address

189 Governor St
Providence, RI 02906

Phone

(401) 331-1008

Fax

(401) 861-6761

NPI assigned

Nov 27, 2006

Last updated

Mar 24, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300924800000",
    "number": "1962578617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 GOVERNOR ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "02906",
            "telephone_number": "401-331-1008",
            "fax_number": "401-861-6761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189 GOVERNOR ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "02906",
            "telephone_number": "401-331-1008",
            "fax_number": "401-861-6761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLAXMAN",
        "first_name": "BERTRAM",
        "middle_name": "ALLEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-27",
        "last_updated": "2011-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "RI",
            "license": "RI4029",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MA",
            "license": "28301",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "243",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000243",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH",
            "identifier": "0300101",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole L Flanagan
• Patricia J Flanagan, MD
• Corey James Flanders, LMHC
• John Flanders, MD
• Timothy P Flanigan, MD
• Norbert Fleisig, MD
• Kathryn Fleming-Ives, MD
• Danielle Fletcher, RN
• Dorothy Patricia Fleury, RN
• Flexible Physical Therapy Inc

• Dermatology Physician in Providence, RI
• Providers in Providence, RI by specialty
• Dermatology Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2011; 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.