Individual provider Active NPI

Haidee Bernades

  • Pediatric Physical Therapist
  • Hinesville, GA
National Provider Identifier
1366639338
Registry record updated Oct 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
PT004546 Issued in GA
Practice address
313 Wexford Dr
Hinesville, GA 31313-4470
Phone
(912) 877-0201
NPI assigned
Oct 3, 2007
Last updated
Oct 3, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X PT004546 GA Primary

Addresses

Primary practice location

313 Wexford Dr
Hinesville, GA 31313-4470

Mailing address

313 Wexford Dr
Hinesville, GA 31313-4470
Phone (912) 877-0201

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
PT004546GAMDPediatric Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1191369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191369600000",
    "number": "1366639338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 WEXFORD DR",
            "city": "HINESVILLE",
            "state": "GA",
            "postal_code": "313134470",
            "telephone_number": "912-877-0201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 WEXFORD DR",
            "city": "HINESVILLE",
            "state": "GA",
            "postal_code": "313134470",
            "telephone_number": "912-877-0201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNADES",
        "first_name": "HAIDEE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-03",
        "last_updated": "2007-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "GA",
            "license": "PT004546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hinesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2007; 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.