Individual provider Active NPI

Harry N Bernard, D.P.M. LTD

  • Foot & Ankle Surgery Podiatrist
  • Saint Charles, MO
National Provider Identifier
1174653554
Registry record updated Apr 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
016002736 Issued in IL
Practice address
34 Green Number 4 Dr
Saint Charles, MO 63303-3336
Phone
(618) 322-4579
Fax
(636) 947-5498
NPI assigned
Mar 6, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 016002736 IL Primary

Addresses

Primary practice location

34 Green Number 4 Dr
Saint Charles, MO 63303-3336

Mailing address

34 Green Number 4 Dr
Saint Charles, MO 63303-3336
Phone (618) 322-4579

Other identifiers 1

IdentifierTypeStateIssuer
016002736MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016002736ILMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Harry N Bernard DPM LTD Foot & Ankle Surgery PastSince Jul 1, 1974 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302739200000",
    "number": "1174653554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 GREEN NUMBER 4 DR",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633033336",
            "telephone_number": "618-322-4579",
            "fax_number": "636-947-5498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 GREEN NUMBER 4 DR",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633033336",
            "telephone_number": "618-322-4579",
            "fax_number": "636-947-5498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNARD",
        "first_name": "HARRY",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "D.P.M. LTD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2011-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016002736",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016002736",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.