Individual provider Active NPI

Bernard Behr Wolfberg, M.D.

  • Psychiatry Physician
  • Alpharetta, GA
National Provider Identifier
1407942972
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
034744 Issued in GA
Practice address
1040 Cambridge Square
Suite D
Alpharetta, GA 30004-1800
Phone
(770) 664-6229
Fax
(770) 664-6684
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 034744 GA Primary

Addresses

Primary practice location

1040 Cambridge Square
Suite D
Alpharetta, GA 30004-1800

Mailing address

1040 Cambridge Square
Suite D
Alpharetta, GA 30004-1800
Phone (770) 664-6229

Other identifiers 1

IdentifierTypeStateIssuer
00473877AMedicaidGA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
034744GAMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407942972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 CAMBRIDGE SQUARE",
            "address_2": "SUITE D",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300041800",
            "telephone_number": "770-664-6229",
            "fax_number": "770-664-6684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 CAMBRIDGE SQUARE",
            "address_2": "SUITE D",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300041800",
            "telephone_number": "770-664-6229",
            "fax_number": "770-664-6684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFBERG",
        "first_name": "BERNARD",
        "middle_name": "BEHR",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "034744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00473877A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.