Active NPI
Bernhard Eric Dietz, M.D.
- Family Medicine Physician
- Henderson, TN
National Provider Identifier
1497759807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 27623
- Practice address
- 116 W Main St
Henderson, TN 38340-2231 - Phone
- (731) 824-2400
- Fax
- (731) 824-0388
- NPI assigned
- Jun 13, 2005
- Last updated
- Feb 10, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 27623 | TN | Primary |
Addresses
Primary practice location
116 W Main St
Henderson, TN 38340-2231
Mailing address
116 W Main St
Henderson, TN 38340-2231
Phone (731) 989-0001
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3077257 | Other | TN | BC/BS OF TENNESSEE |
| 7864 | Other | TN | TLC-MEMPHIS MANAGED CARE |
| 3818356 | Medicaid | TN | |
| 80121733 | Other | TN | METRAHEALTH |
| 5572559 | Other | TN | AETNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Jefferson Medical College of Thomas Jefferson University, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1314 Hwy 45 Bypass
Suite a
Henderson, TN 38340-4003
Phone (731) 989-0001
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27623 | TN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frix-Jennings Clinic PC | Family Medicine | Current | Accepting new patients |
Locations
116 W Main St
Henderson, TN 38340
Phone (731) 427-5581
1314 US Highway 45 N
Henderson, TN 38340
Phone (731) 983-5716
1314 US Highway 45 N
#A
Henderson, TN 38340
Phone (731) 989-0001
Interoperability endpoints
- bernhard.dietz.1@29749.direct.athenahealth.com
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Henderson, TN
- NPI 1174749469
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Adoration Home Health Brownsville
- Home Health Agency
- Brownsville, TN
- NPI 1639659675
-
- General Acute Care Hospital
- Jackson, TN
- NPI 1093705428
-
- Home Health Agency
- Jackson, TN
- NPI 1932355997
-
- Home Health Agency
- Parsons, TN
- NPI 1548211717
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612915200000",
"number": "1497759807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "116 W MAIN ST",
"city": "HENDERSON",
"state": "TN",
"postal_code": "383402231",
"telephone_number": "731-989-0001",
"fax_number": "731-520-0064"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "116 W MAIN ST",
"city": "HENDERSON",
"state": "TN",
"postal_code": "383402231",
"telephone_number": "731-824-2400",
"fax_number": "731-824-0388"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIETZ",
"first_name": "BERNHARD",
"middle_name": "ERIC",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-06-13",
"last_updated": "2021-02-10",
"certification_date": "2021-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TN",
"license": "27623",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS OF TENNESSEE",
"identifier": "3077257",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TLC-MEMPHIS MANAGED CARE",
"identifier": "7864",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3818356",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "METRAHEALTH",
"identifier": "80121733",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5572559",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Henderson, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.