Jate William Bernard, MD

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Knoxville, TN

NPI 1386479558 · NPPES record last updated Mar 26, 2025

Key facts

NPI
1386479558
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
1924 Alcoa Hwy # U-11
Knoxville, TN 37920-1511
Phone
(865) 305-9230
Fax
(865) 305-6958
NPI assigned
Sep 5, 2024
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20250525000002 TN Order and Referring Only - Urology
Practitioner - Urology
4385163104

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

1924 Alcoa Hwy # U-11
Knoxville, TN 37920-1511

Mailing address

1924 Alcoa Hwy # U-11
Knoxville, TN 37920-1511
Phone (865) 305-9230

Other providers in Knoxville, TN

All providers in Knoxville, TN · Student in an Organized Health Care Education/Training Program in Tennessee

Sources for this page

Verify at the official NPI Registry.