Bernardo Anderson

Key facts

NPI

1114665452

Entity type

Individual (NPI type 1)

Primary specialty

Physical Therapist 225100000X

License

5072 (NV)

Practice address

5228 Koa Ave
Las Vegas, NV 89122-5317

Phone

(702) 423-8998

NPI assigned

May 26, 2022

Sex

Male

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Specialties & licenses

Addresses

Other names

• Bernardo Almadin-Anderson Other name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 22, 2024.

{
    "created_epoch": "1653523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719014400000",
    "number": "1114665452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5228 KOA AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891225317",
            "telephone_number": "702-423-8998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5228 KOA AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891225317",
            "telephone_number": "702-423-8998"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7819 Rocky Springs Rd",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217022824",
            "country_code": "US",
            "telephone_number": "877-407-3422",
            "fax_number": "877-407-4329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "BERNARDO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-26",
        "last_updated": "2024-06-22",
        "certification_date": "2024-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "24975",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "13213002-2401",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "5072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BERNARDO",
            "last_name": "ALMADIN-ANDERSON",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Las Vegas, NV

• Austin Scott Anderson, DO
• Avrohom Anderson, LMSW
• Azelynn Anderson
• Belafonte Anderson
• Belmont W. Anderson, DPM
• Brian Anderson, O.D.
• Brian Anderson
• Brittany Andi Anderson
• Canh Anderson, R.P.
• Carla J Anderson, MD

All providers in Las Vegas, NV · Physical Therapist in Nevada