Active NPI
Andrew Schutz Bernhardson, M.D.
- Orthopaedic Surgery Physician
- Jacksonville, FL
National Provider Identifier
1396056578
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 54352
- Practice address
- 2005 Knight Lane BLDG H
Navy Medicine Support Command, Medical Staff Services
Jacksonville, FL 32212-0140 - Phone
- (619) 532-6400
- NPI assigned
- Jun 23, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Orthopaedic Surgery Physician | 207X00000X | 54352 | MN | Primary |
Addresses
Primary practice location
2005 Knight Lane BLDG H
Navy Medicine Support Command, Medical Staff Services
Jacksonville, FL 32212-0140
Mailing address
3001 Green Bay Rd
North Chicago, IL 60064-3048
Phone (612) 382-1616
Other practice location 1
3001 Green Bay Rd
North Chicago, IL 60064-3048
Phone (612) 382-1616
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 54352 | MN | MD | Orthopaedic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624233600000",
"number": "1396056578",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3001 GREEN BAY RD",
"city": "NORTH CHICAGO",
"state": "IL",
"postal_code": "600643048",
"telephone_number": "612-382-1616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2005 KNIGHT LANE BLDG H",
"address_2": "NAVY MEDICINE SUPPORT COMMAND, MEDICAL STAFF SERVICES",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322120140",
"telephone_number": "619-532-6400"
}
],
"practiceLocations": [
{
"address_1": "3001 Green Bay Rd",
"address_purpose": "LOCATION",
"city": "North Chicago",
"state": "IL",
"postal_code": "600643048",
"country_code": "US",
"telephone_number": "612-382-1616",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BERNHARDSON",
"first_name": "ANDREW",
"middle_name": "SCHUTZ",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-06-23",
"last_updated": "2021-06-21",
"certification_date": "2021-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "MN",
"license": "54352",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.