Active NPI
Bruce Jeremy Bernie, M.D.
- Gynecology Physician
- Dayton, OH
National Provider Identifier
1194720987
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecology Physician
- License
- 35.038152
- Practice address
- 9000 N Main St
Suite 234
Dayton, OH 45415-1180 - Phone
- (937) 277-8988
- Fax
- (937) 832-2421
- NPI assigned
- Jun 17, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gynecology Physician | 207VG0400X | 35.038152 | OH | Primary |
Addresses
Primary practice location
9000 N Main St
Suite 234
Dayton, OH 45415-1180
Mailing address
9000 N Main St
Suite 234
Dayton, OH 45415-1180
Phone (937) 277-8988
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0332456 | Medicaid | OH |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35.038152 | OH | MD | Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118966400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315353600000",
"number": "1194720987",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9000 N MAIN ST",
"address_2": "SUITE 234",
"city": "DAYTON",
"state": "OH",
"postal_code": "454151180",
"telephone_number": "937-277-8988",
"fax_number": "937-832-2421"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9000 N MAIN ST",
"address_2": "SUITE 234",
"city": "DAYTON",
"state": "OH",
"postal_code": "454151180",
"telephone_number": "937-277-8988",
"fax_number": "937-832-2421"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERNIE",
"first_name": "BRUCE",
"middle_name": "JEREMY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-17",
"last_updated": "2011-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "207VG0400X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": "OH",
"license": "35.038152",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0332456",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 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.