KENNETH BROOKE BINGHAM (NPI# 1770131104) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770131104 |
| Entity Type | Individual |
| Full Name | KENNETH BROOKE BINGHAM |
| Credential | PA |
| Practice Address |
100 Three Rivers Dr Ne Ste A Rome GA 30161-4999 |
| Mailing Address |
4600 Roswell Rd Unit 515 Atlanta GA 30342-3091 |
| Practice Telephone | 7092920040 |
| Practice Fax Number | 7063780556 |
| Enumeration Date | 2019-08-28 |
| Last Update Date | 2019-10-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
9270 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3240 Northeast Expy Ne, Atlanta, GA 303414003 | 4044809330 |
| Street Address |
100 THREE RIVERS DR NE STE A |
| City | ROME |
| State | GA |
| Zip Code | 30161-4999 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477994325 | Zachary Thomas | Specialist/Technologist | 100 Three Rivers Dr Ne Ste A, Rome, GA 30161-4999 | 2013-07-08 |
| 1174039598 | Joseph John Borrillo | Physician Assistant | 100 Three Rivers Dr Ne Ste A, Rome, GA 30161-4999 | 2017-12-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265069256 | Three Rivers Housing and Development Corporation | Chore Provider | 326 W. 9th St, Rome, GA 30161 | 2020-03-27 |
| 1144865957 | Eric Alan Fuller | Audiologist-Hearing Aid Fitter | 700 East 2nd Street, Suite C, Rome, GA 30161 | 2019-11-15 |
| 1003394883 | Cindy V Shelton | Health Educator | 204 E 1st Ave, Rome, GA 30161 | 2018-08-02 |
| 1083153597 | Julie Oglesby Allen | Counselor | 1 S Broad St Sw Ste 5, Rome, GA 30161 | 2017-02-16 |
| 1902299530 | Michael Thomas Phillips | Pharmacist | 2005 Maple Street, Rome, GA 30161 | 2015-03-06 |
| 1407259112 | Angela Smith | Community/Behavioral Health | 109 John Maddox Suite 200, Rome, GA 30161 | 2014-10-08 |
| 1215344379 | Nancy Patel | Pharmacist | 1421 North Broad St, Rome, GA 30161 | 2014-07-21 |
| 1821336629 | Wendy Pence | Nurse Practitioner | 3001 Turner Mccall Blvd, Rome, GA 30161 | 2013-01-29 |
| 1558526202 | Marilyn Teresa Ringstaff | Registered Nurse | 1513 Dean St., Rome, GA 30161 | 2008-07-22 |
| 1134310147 | Reneka L Dobbs-jackson | Family Medicine | 420 E 2nd Ave Ste 103, Rome, GA 30161 | 2007-08-05 |
| Find all providers in zip 30161 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962779561 | 1st Call Surgical Services | Physician Assistant | 205 Myrtle St Sw, Rome, GA 30161-4445 | 2011-11-27 |
| 1174039598 | Joseph John Borrillo | Physician Assistant | 100 Three Rivers Dr Ne Ste A, Rome, GA 30161-4999 | 2017-12-21 |
| 1992149215 | Joshua A Suggs | Physician Assistant | 100 Three Rivers Dr Ne, Ste A, Rome, GA 30161-4999 | 2013-04-18 |
| 1609969823 | Colin O Matheny | Physician Assistant | 100 Three Rivers Dr Ne, Rome, GA 30161-4999 | 2006-10-02 |
| 1306854005 | Tiffany D Bowerman | Physician Assistant | 100 Three Rivers Dr Ne, Rome, GA 30161-4999 | 2006-08-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336748409 | Jesse Aaron Denson | Physician Assistant | 2046 Point Grey Ct Nw, Kennesaw, GA 30152-8276 | 2020-10-20 |
| 1568074227 | James D Craig | Physician Assistant | 3210 New College Way, Cumming, GA 30041-2896 | 2020-08-23 |
| 1982223244 | Keith Hawkins | Physician Assistant | 8498 Glenview St, Douglasville, GA 30134-5639 | 2020-04-15 |
| 1639704307 | Spectrum Surgical LLC | Physician Assistant | 3142 Highway 278 Nw # 135, Covington, GA 30014-2304 | 2020-03-03 |
| 1255962205 | Songthu Nguyen | Physician Assistant | 6119 Foxcroft Ct, Morrow, GA 30260-1069 | 2020-01-29 |
| 1265071229 | Stellar Surgical Assisting | Physician Assistant | 3446 Winder Hwy Ste M-322, Flowery Branch, GA 30542-3007 | 2019-12-22 |
| 1194363366 | Clara A Matthews | Physician Assistant | 1930 Windsor Creek Drive Sw, Conyers, GA 30094 | 2019-12-18 |
| 1922640739 | Jeremiah George Blair | Physician Assistant | 61 Whitcher St Suite 2100, Marietta, GA 30060 | 2019-10-14 |
| 1710528401 | Hannah Ingrid Boomgarden | Physician Assistant | 1467 Harper Street Hb 5040, Augusta, GA 30912-5775 | 2019-10-03 |
| 1891257028 | Symmetry Surgical Billing LLC | Physician Assistant | 5135 Mirror Lake Dr, Cumming, GA 30028-7216 | 2019-04-05 |
| 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.