Individual provider Active NPI

Mary Lynn Bernard, ARNP

  • Family Nurse Practitioner
  • Spokane, WA
National Provider Identifier
1457344152
Registry record updated Apr 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP30006845 Issued in WA
Practice address
421 S Division St
Spokane, WA 99202-1331
Phone
(509) 474-2100
NPI assigned
Aug 26, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP30006845 WA Primary

Addresses

Primary practice location

421 S Division St
Spokane, WA 99202-1331

Mailing address

PO Box 421
Liberty Lake, WA 99019-0421
Phone (509) 474-2100

Other practice location 1

2923 E 29th Ave
Spokane, WA 99223-4811
Phone (888) 227-3312

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mbernard314561@wm.providencedirect.org Direct
Direct Messaging Address mbernard314561@wm.providencedirect.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090112000262 WA Practitioner - Nurse Practitioner 3971585647 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health and Services WashingtonGroup PAC ID 0345139929, 778 clinicians

Practice addresses (Care Compare)

1200 E Columbia Ave
Colville, WA 99114-3354
Phone (509) 684-3701

16528 E Desmet CT
Spokane, WA 99216-3522

421 S Division St
Spokane, WA 99202-1331
Phone (509) 474-2100

551 E Hawthorne Rd
Spokane, WA 99218-1417
Phone (509) 489-2369

Hospital & facility affiliations

  • Prov Sacred HRT Med Ctr & Childs Hosp. Hospital, Spokane, WA, CCN 500054

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington CurrentSince Sep 8, 2013 Accepting new patients
Providence Health & Services Washington CurrentSince Sep 8, 2013 Accepting new patients
Providence Health & Services - Washington Past Accepting new patients

Locations

1200 E Columbia Ave
Colville, WA 99114
Phone (509) 684-3701

5633 N Lidgerwood St
Spokane, WA 99208
Phone (509) 482-0111

551 E Hawthorne Rd
Spokane, WA 99218
Phone (509) 252-1900

101 W 8th Ave
Ste 100
Spokane, WA 99204
Phone (509) 474-2880

2923 E 29th Ave
Spokane, WA 99223
Phone (509) 626-9820

421 S Division St
Spokane, WA 99202
Phone (509) 474-2100

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618531200000",
    "number": "1457344152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 421",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190421",
            "telephone_number": "509-474-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 S DIVISION ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992021331",
            "telephone_number": "509-474-2100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2923 E 29th Ave",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992234811",
            "country_code": "US",
            "telephone_number": "888-227-3312",
            "fax_number": "509-622-2695",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERNARD",
        "first_name": "MARY",
        "middle_name": "LYNN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-26",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP30006845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mbernard314561@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "421 S Division St",
            "city": "Spokane",
            "state": "WA",
            "country_code": "US",
            "postal_code": "992021331",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mbernard314561@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2923 E 29th Ave",
            "city": "Spokane",
            "state": "WA",
            "country_code": "US",
            "postal_code": "992234811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.