Active NPI
Norma Jean Bertrand, APRN-C
- Family Nurse Practitioner
- Modesto, CA
National Provider Identifier
1346668563
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 12586
- Practice address
- 3430 Tully Rd Ste 20123
Modesto, CA 95350-0840 - Phone
- (209) 324-3158
- NPI assigned
- Apr 3, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 12586 | CA | Primary |
Addresses
Primary practice location
3430 Tully Rd Ste 20123
Modesto, CA 95350-0840
Mailing address
3430 Tully Rd Ste 20123
Modesto, CA 95350-0840
Phone (209) 324-3158
Other names 1
- Miss Norma Jean Rivard
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
- Opted out of Medicare
- Yes, effective May 24, 2023 through May 24, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1396483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1396483200000",
"number": "1346668563",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3430 TULLY RD STE 20123",
"city": "MODESTO",
"state": "CA",
"postal_code": "953500840",
"telephone_number": "209-324-3158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3430 TULLY RD STE 20123",
"city": "MODESTO",
"state": "CA",
"postal_code": "953500840",
"telephone_number": "209-324-3158"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERTRAND",
"first_name": "NORMA JEAN",
"name_prefix": "Ms.",
"credential": "APRN-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-04-03",
"last_updated": "2014-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "12586",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "NORMA",
"last_name": "RIVARD",
"middle_name": "JEAN",
"prefix": "MISS",
"credential": "APRN-C",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.