Bernard Alvan Tisdale, MD

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

0101040236 Issued in VA

Practice address

1109 W Marshall St
Richmond, VA 23220-3835

Phone

(804) 257-7337

Fax

(804) 359-6898

NPI assigned

Nov 10, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Bernard a. Tisdale, M.D., P.C

  • Specialist
  • Richmond, VA
  • NPI 1215030416
  NPD Authorized official
• Columbia Healthcare of Central Virginia Inc

  • Plastic Surgery Physician
  • Richmond, VA
  • NPI 1417946450
  NPD (past)
• Commonwealth Primary Care

  • Family Medicine Physician
  • Richmond, VA
  • NPI 1750571287
  NPD (past)
• Virginia Emergency Physicians LLP

  • Emergency Medicine Physician
  • Richmond, VA
  • NPI 1134475999
  NPD (past)

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124009600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 W MARSHALL ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232203835",
            "telephone_number": "804-257-7337",
            "fax_number": "804-359-6898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 W MARSHALL ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232203835",
            "telephone_number": "804-257-7337",
            "fax_number": "804-359-6898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TISDALE",
        "first_name": "BERNARD",
        "middle_name": "ALVAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "VA",
            "license": "0101040236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5866740",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taryn Elisabeth Tinsley, B.A
• Margaret A. Tipple, M.D.
• Gregory J Tipton
• Camila Tirado
• Mylady Tirado, P.T.A
• Robert C Tisdale, RPH
• Karen A Tisdel, PHARMD
• Teresa Marie Tivenan, LCSW
• TLC Residential Services, Inc.
• TLC United Helpers LLC

• Radiation Oncology Physician in Richmond, VA
• Providers in Richmond, VA by specialty
• Radiation Oncology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.