Holly a. Berndt, MD, PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

059372 Issued in GA

Legal business name

HOLLY A. BERNDT, MD, PC

Practice address

103 Church St
Hiawassee, GA 30546-3223

Phone

(706) 896-4673

Fax

(706) 896-3992

NPI assigned

Jan 21, 2011

Last updated

Jan 21, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Ruth B Mustin

Title

Billing Clerk

Phone

(706) 896-9274

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1295568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295568000000",
    "number": "1023313095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 CHURCH ST",
            "city": "HIAWASSEE",
            "state": "GA",
            "postal_code": "305463223",
            "telephone_number": "706-896-4673",
            "fax_number": "706-896-3992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 CHURCH ST",
            "city": "HIAWASSEE",
            "state": "GA",
            "postal_code": "305463223",
            "telephone_number": "706-896-4673",
            "fax_number": "706-896-3992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLY A. BERNDT, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-21",
        "last_updated": "2011-01-21",
        "status": "A",
        "authorized_official_last_name": "MUSTIN",
        "authorized_official_first_name": "RUTH",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "BILLING CLERK",
        "authorized_official_telephone_number": "706-896-9274",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "059372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118611205A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5908767",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Hiawassee, GA
• Providers in Hiawassee, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2011; 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.