DR. WILFRIDO D BERNARDO M.D. NPI 1003801887

General Practice in Carthage, TN

Individual Male General Practice

About WILFRIDO BERNARDO

Wilfrido Bernardo is a provider established in Carthage, Tennessee and his medical specialization is general practice. The NPI number of Wilfrido Bernardo is 1003801887 and was assigned on September 2005. The practitioner's primary taxonomy code is 208D00000X with license number 11479 (TN). The provider is registered as an individual and his NPI record was last updated 11 years ago.

NPI

1003801887

Provider NameDR. WILFRIDO D BERNARDO M.D.
Provider Location Address130 LEBANON HWY SUITE B CARTHAGE, TN 37030
Provider Mailing AddressPO BOX 176 CARTHAGE, TN 37030
GenderMale
NPI Entity TypeIndividual
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date09-16-2005
Last Update Date03-05-2008

Primary Taxonomy

Taxonomy Code208D00000X
ClassificationGeneral Practice
TypeAllopathic & Osteopathic Physicians
License No.11479
License StateTN

Business Address

DR. WILFRIDO D BERNARDO M.D.
130 LEBANON HWY
SUITE B
CARTHAGE, TN
ZIP 37030
Phone: (615) 735-0700
Fax: (615) 735-5451

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Mailing Address

DR. WILFRIDO D BERNARDO M.D.
PO BOX 176
CARTHAGE, TN
ZIP 37030
Phone: (615) 735-0700
Fax: (615) 735-5451

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
B03418MEDICARE UPIN (02)
3170708MEDICARE ID-TYPE UNSPECIFIED (04)
3170708MEDICAID (05)TN

Other Providers at the same location


The following 6 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1063532489 GLORIA J HART RN
Individual
Registered Nurse (Diabetes Educator)130 LEBANON HWY
CARTHAGE, TN 37030
(615) 735-5320
1316928393 JANE BASS TURNER NP
Individual
Nurse Practitioner (Gerontology)130 LEBANON HWY SUITE B
CARTHAGE, TN 37030
(615) 735-0700
1578693545FRANK T RUTHERFORD HOSPITAL INC
Organization
General Acute Care Hospital130 LEBANON HWY
CARTHAGE, TN 37030
(615) 735-9815
1629082466FRANK T RUTHERFORD MEMORIAL HOSPITAL, INC
Organization
General Acute Care Hospital (Critical Access)130 LEBANON HWY
CARTHAGE, TN 37030
(615) 735-9815
1740566777 ANNA KIRBY LOCKE PA
Individual
Physician Assistant (Medical)130 LEBANON HWY SUITE B
CARTHAGE, TN 37030
(615) 735-0700
1801814629FRANK T RUTHERFORD MEMORIAL HOSPITAL, INC
Organization
General Acute Care Hospital (Critical Access)130 LEBANON HWY
CARTHAGE, TN 37030
(615) 735-9815

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.

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