Bedford Hudson Berrey, MD

Primary specialty

Surgical Oncology PhysicianTaxonomy code 2086X0206X

License

ME74636 Issued in FL

Practice address

1301 Palm Ave
Jacksonville, FL 32207-8432

Phone

(904) 202-7300

Fax

(904) 202-7433

NPI assigned

Mar 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Baptist MD Anderson Cancer Physicians Inc

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Jacksonville, FL
  • NPI 1609286897
  NPD (past)

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576022400000",
    "number": "1114988409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 45278",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322325278",
            "telephone_number": "904-202-2092",
            "fax_number": "904-393-7603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 PALM AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078432",
            "telephone_number": "904-202-7300",
            "fax_number": "904-202-7433"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1325 San Marco Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322078566",
            "country_code": "US",
            "telephone_number": "904-346-3465",
            "fax_number": "904-396-0388",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERREY",
        "first_name": "BEDFORD",
        "middle_name": "HUDSON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "ME74636",
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "FL",
            "license": "ME74636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2505126-00",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR CARE",
            "identifier": "200044245",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000809718B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Eve Bernstein, D.C
• Anne Laurelle Bernstein, MD
• Duane Ira Bernstein, DMD
• Scott Bernstein, PTA
• Thomas Berquist, MD
• Haytza Yanisse Berroteran, R.PH.
• Amie M Berry, LCSW
• Caitlyn Berry
• Leslie Berry, RD
• Lindsay Berry, OTR/L

• Surgical Oncology Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Surgical Oncology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2019; 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.