Individual provider Active NPI

Jeffrey Tucker Berard, B.A., D.C

  • Chiropractor
  • Plantation, FL
National Provider Identifier
1255462099
Registry record updated Aug 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH8191 Issued in FL
Practice address
286 S University Dr
Plantation, FL 33324-3341
Phone
(954) 452-4600
Fax
(954) 452-4652
NPI assigned
Mar 7, 2007
Last updated
Aug 20, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH8191 FL Primary

Addresses

Primary practice location

286 S University Dr
Plantation, FL 33324-3341

Mailing address

4710 Eastman Ave
Midland, MI 48641-1824
Phone (772) 359-8108

Other identifiers 1

IdentifierTypeStateIssuer
381463700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140527001978 MI Practitioner - Chiropractic 0446406276 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midland ChiropracticGroup PAC ID 9638392020, 12 clinicians

Practice addresses (Care Compare)

317 E Wackerly St
Midland, MI 48642-7062
Phone (989) 832-9300

4710 Eastman Ave
Midland, MI 48640-2606

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Bachelor of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Midland Chiropractic Chiropractor CurrentSince Nov 30, 2013 Accepting new patients
Midland Chiropractic Chiropractor Past Accepting new patients
Midland Physical Therapy Sports Rehab PastSince Oct 29, 2015 Accepting new patients

Locations

115 S Main St
Ste 4B
Freeland, MI 48623
Phone (989) 341-1070

4710 Eastman Ave
Midland, MI 48640
Phone (989) 341-1070

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376956800000",
    "number": "1255462099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4710 EASTMAN AVE",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486411824",
            "telephone_number": "772-359-8108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "286 S UNIVERSITY DR",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333243341",
            "telephone_number": "954-452-4600",
            "fax_number": "954-452-4652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERARD",
        "first_name": "JEFFREY",
        "middle_name": "TUCKER",
        "name_prefix": "Dr.",
        "credential": "B.A.,  D.C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2013-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH8191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "381463700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.