BRENT J BEDKE (NPI# 1417186305) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417186305 |
| Entity Type | Individual |
| Full Name | BRENT J BEDKE |
| Credential | MD |
| Practice Address |
1740 Sycamore Ave Ste C Kingman AZ 86409-1039 |
| Practice Telephone | 5072842511 |
| Mailing Telephone | 5072842511 |
| Enumeration Date | 2009-07-13 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
48849 | AZ | Allopathic & Osteopathic Physicians |
| N | 207ZP0105X |
Pathology Specialization: Clinical Pathology/Laboratory Medicine |
52935 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 916106 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 200 1st St Sw, Rochester, MN 559050001 | 5072842511 |
| Street Address |
1740 SYCAMORE AVE STE C |
| City | KINGMAN |
| State | AZ |
| Zip Code | 86409-1039 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437695731 | Medical Laboratory Specialty, Inc | Clinical Medical Laboratory | 3636 St, Kingman, AZ 86409 | 2017-01-10 |
| 1003219007 | Premier Home Health Agency | Home Health | 3555 Western Ave, Kingman, AZ 86409 | 2014-10-03 |
| 1558774984 | Fernando Velez | Pharmacist | 2003 Roy Rogers Way, Kingman, AZ 86409 | 2014-06-03 |
| 1013227834 | Route 66 Cab Inc | Taxi | 3595 E Us Highway 66, Kingman, AZ 86409 | 2010-10-14 |
| 1740503374 | Route 66 Cab Inc. | Taxi | 3595 East Hwy 66, Kingman, AZ 86409 | 2010-03-10 |
| 1649409145 | Arizona Cvs Stores, L.L.C. | Durable Medical Equipment & Medical Supplies | 3501 Stockton Hill Rd, Kingman, AZ 86409 | 2009-07-07 |
| 1790922896 | Jack Cheng-tsung Hou | Urology | 1739 E Beverly Ave Ste 106, Kingman, AZ 86409 | 2009-01-12 |
| 1710184726 | Michele F Epstein | Internal Medicine | 3571 N Moore Street, Kingman, AZ 86409 | 2007-07-02 |
| 1013118306 | Conchita O Mercado | Dentist | 1101 Riata Valley Rd, Kingman, AZ 86409 | 2007-05-31 |
| 1366585945 | Deering Therapy Services Ltd | Occupational Therapist | 1841 Morrow Ave, Kingman, AZ 86409 | 2007-02-14 |
| Find all providers in zip 86409 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386190718 | Monolith Diagnostics, PC | Pathology | 1740 Sycamore Ave, Ste. C, Kingman, AZ 86409-0942 | 2016-08-26 |
| 1962630863 | Ryan E Swapp | Pathology | 3269 Stockton Hill Rd, Kingman, AZ 86409-3619 | 2009-06-30 |
| 1588729685 | Donald H Nelson | Pathology | 3269 N Stockton Hill Rd, Kingman, AZ 86409-3619 | 2006-12-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881200632 | Eric David Peters | Pathology | 11545 E Quiet Valley Pl, Tucson, AZ 85749-8884 | 2020-09-17 |
| 1609434794 | Peak Diagnostic Services LLC | Pathology | 3033 N 44th St Ste 200, Phoenix, AZ 85018-7244 | 2019-06-03 |
| 1144638008 | Michael Moore | Pathology | 8796 N Western Red Cedar Dr, Tucson, AZ 85743-7146 | 2014-07-23 |
| 1356683155 | Belinda Liu Sun | Pathology | 1501 N Campbell Ave Rm 5205, Tucson, AZ 85724-7232 | 2013-03-20 |
| 1669717815 | Guadalupe Hortencia Manriquez | Pathology | 7601 N Calle Sin Envidia, 31, Tucson, AZ 85718-1271 | 2012-11-29 |
| 1407164486 | Aztec Pathology LLC | Pathology | 2538 E University Dr Ste 100, Phoenix, AZ 85034-6925 | 2010-09-23 |
| 1336471846 | Peter Salomon | Pathology | 6344 E Miramar Dr, Tucson, AZ 85715-3115 | 2010-02-08 |
| 1427387372 | Meryl Harold Haber | Pathology | 8464 E Charter Oak Dr, Scottsdale, AZ 85260-5315 | 2009-12-23 |
| 1538492400 | Paul Boschen Visconti | Pathology | 33619 N 79th Way, Scottsdale, AZ 85266-4241 | 2009-09-10 |
| 1063666543 | Renuka Pathi | Pathology | 22216 N 36th St, Phoenix, AZ 85050-7396 | 2008-11-10 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.