1396305389 NPI number — DR. BRIANNA RACHELLE BINGHAM DO

Table of content: DR. BRIANNA RACHELLE BINGHAM DO (NPI 1396305389)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396305389 NPI number — DR. BRIANNA RACHELLE BINGHAM DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BINGHAM
Provider First Name:
BRIANNA
Provider Middle Name:
RACHELLE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CLINE
Provider Other First Name:
BRIANNA
Provider Other Middle Name:
RACHELLE
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
DO
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1396305389
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/08/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1208 COMMERCE ST APT 401
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LYNCHBURG
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24504-1869
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
816-256-4733
Provider Business Mailing Address Fax Number:
800-856-9143

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1201 LANDMARK AVE STE 5
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LIBERTY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64068-3738
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-256-4733
Provider Business Practice Location Address Fax Number:
800-856-9143
Provider Enumeration Date:
06/20/2019

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  2026008908 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207R00000X , with the licence number: 05-46446 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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