Mitchel L. Bernstrom, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25101 Issued in IA

Practice address

2055 Kimball Ave Ste 400
Waterloo, IA 50702

Phone

(319) 272-0000

Fax

(319) 272-1329

NPI assigned

May 28, 2006

Last updated

Jun 27, 2018By the provider in NPPES

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

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.

• Floyd County Memorial Hospital Commission

  • Critical Access Hospital
  • Charles City, IA
  • NPI 1265402390

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530057600000",
    "number": "1265489967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 KIMBALL AVE STE 400",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025047",
            "telephone_number": "319-272-0000",
            "fax_number": "319-272-1329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 KIMBALL AVE STE 400",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "50702",
            "telephone_number": "319-272-0000",
            "fax_number": "319-272-1329"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2055 Kimball Ave Ste 400",
            "address_purpose": "LOCATION",
            "city": "Waterloo",
            "state": "IA",
            "postal_code": "507025047",
            "country_code": "US",
            "telephone_number": "319-272-0000 x1343",
            "fax_number": "319-272-1329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERNSTROM",
        "first_name": "MITCHEL",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-28",
        "last_updated": "2018-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "25101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2029272",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shanon Dione Bennett, PA-C
• Bennhook PLLC
• Samuel Bernard, DPM
• Frederick Morgan Berneking, PHARM. D.
• Stephanie Berns, PHARMD
• Carrie Berry, FNP
• Douglas M Besch, PHARMD, MBA
• Better Health Chiropractic, Inc.
• Better Living Care
• Jon Beyer, BS PHARM, R. PH.

• Family Medicine Physician in Waterloo, IA
• Providers in Waterloo, IA by specialty
• Family Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2018; 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.