John R Bernard, M.D.

Key facts

NPI

1023005238

Entity type

Individual (NPI type 1)

Primary specialty

Family Medicine Physician 207Q00000X

License

0425085 (KS)

Practice address

12330 Metcalf Ave
Suite 400
Overland Park, KS 66213-1324

Phone

(913) 317-7990

Fax

(913) 317-7018

NPI assigned

Oct 3, 2005

Sex

Male

Sole proprietor

No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• College Park Family Care Center PA Family Medicine Physician · Overland Park, KS · NPI 1740248772
  NPD FAMILY MEDICINE

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 15, 2013.

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360886400000",
    "number": "1023005238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12330 METCALF AVE",
            "address_2": "SUITE 400",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662131324",
            "telephone_number": "913-317-7990",
            "fax_number": "913-317-7018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12330 METCALF AVE",
            "address_2": "SUITE 400",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662131324",
            "telephone_number": "913-317-7990",
            "fax_number": "913-317-7018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNARD",
        "first_name": "JOHN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-03",
        "last_updated": "2013-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "0425085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jennifer P Bernard, M.D.
• Jeanette M Bernhard
• Alec Bernstein, M.A., BCBA
• Vanessa Berrey
• Lisa Berry, OT
• Marshall B Berry, RPH

All providers in Overland Park, KS · Family Medicine Physician in Kansas