Melissa Rose Bernt, LMP

Primary specialty

ContractorTaxonomy code 171W00000X

License

MA00020546 Issued in WA

Practice address

77 SW Russell Ave
Stevenson, WA 98648-9198

Phone

(360) 521-1523

NPI assigned

Mar 16, 2017

Last updated

Mar 16, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1489622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489622400000",
    "number": "1376084848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 302",
            "address_2": "33 EAST CASCADE DRIVE",
            "city": "NORTH BONNEVILLE",
            "state": "WA",
            "postal_code": "986390302",
            "telephone_number": "360-521-1523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 SW RUSSELL AVE",
            "city": "STEVENSON",
            "state": "WA",
            "postal_code": "986489198",
            "telephone_number": "360-521-1523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNT",
        "first_name": "MELISSA",
        "middle_name": "ROSE",
        "name_prefix": "Ms.",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-16",
        "last_updated": "2017-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "WA",
            "license": "MA00020546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CREDENTIALS FOR STATE OF WASHINGTON",
            "identifier": "MA00020546",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Monty J Buettner

• Contractor in Stevenson, WA
• Providers in Stevenson, WA by specialty
• Contractor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2017; 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.