Individual provider Active NPI

Mark Bernhard, D.C.

  • Chiropractor
  • Santa Cruz, CA
National Provider Identifier
1013089739
Registry record updated Apr 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC0157521 Issued in CA
Practice address
616 Frederick St
Santa Cruz, CA 95062-2203
Phone
(831) 423-2322
Fax
(831) 423-2325
NPI assigned
Nov 15, 2006
Last updated
Apr 4, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC0157521 CA Primary

Addresses

Primary practice location

616 Frederick St
Santa Cruz, CA 95062-2203

Mailing address

616 Frederick St
Santa Cruz, CA 95062-2203
Phone (831) 423-2322

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC0157521CAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333497600000",
    "number": "1013089739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 FREDERICK ST",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950622203",
            "telephone_number": "831-423-2322",
            "fax_number": "831-423-2325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 FREDERICK ST",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950622203",
            "telephone_number": "831-423-2322",
            "fax_number": "831-423-2325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNHARD",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2012-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC0157521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2012; 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.