Wilfrido D Bernardo, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

11479 Issued in TN

Practice address

130 Lebanon Hwy
Suite B
Carthage, TN 37030-2955

Phone

(615) 735-0700

Fax

(615) 735-5451

NPI assigned

Sep 16, 2005

Last updated

Mar 5, 2008By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1126828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204675200000",
    "number": "1003801887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 176",
            "city": "CARTHAGE",
            "state": "TN",
            "postal_code": "370300176",
            "telephone_number": "615-735-0700",
            "fax_number": "615-735-5451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 LEBANON HWY",
            "address_2": "SUITE B",
            "city": "CARTHAGE",
            "state": "TN",
            "postal_code": "370302955",
            "telephone_number": "615-735-0700",
            "fax_number": "615-735-5451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNARDO",
        "first_name": "WILFRIDO",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-16",
        "last_updated": "2008-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TN",
            "license": "11479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3170708",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Carthage, TN
• Providers in Carthage, TN by specialty
• General Practice Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2008; 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.