Individual provider Active NPI

Bernadette S Myers

  • Prosthetic/Orthotic Supplier
  • Charlotte, NC
National Provider Identifier
1245012335
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
86-2295235 Issued in NC
Practice address
537 W Sugar Creek Rd Ste 202
Charlotte, NC 28213-6102
Phone
(704) 910-2141
NPI assigned
Oct 16, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X 86-2295235 NC Primary

Addresses

Primary practice location

537 W Sugar Creek Rd Ste 202
Charlotte, NC 28213-6102

Mailing address

12705 Winter Hazel Rd Apt 101
Charlotte, NC 28278-7739
Phone (980) 777-0378

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
86-2295235NCMDProsthetic/Orthotic Supplier

NPI Registry JSON

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

{
    "created_epoch": "1697414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1245012335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12705 WINTER HAZEL RD APT 101",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282787739",
            "telephone_number": "980-777-0378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "537 W SUGAR CREEK RD STE 202",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282136102",
            "telephone_number": "704-910-2141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "BERNADETTE",
        "middle_name": "S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-16",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NC",
            "license": "86-2295235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; 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.