Individual provider Active NPI

Andrew J St. Bernard, D.C.

  • Chiropractor
  • Woodstock, GA
National Provider Identifier
1548559487
Registry record updated Aug 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR008789 Issued in GA
Practice address
1910 Eagle Dr Ste 100
Woodstock, GA 30189
Phone
(678) 490-8176
NPI assigned
Mar 31, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR008789 GA Primary

Addresses

Primary practice location

1910 Eagle Dr Ste 100
Woodstock, GA 30189

Mailing address

1910 Eagle Dr Ste 100
Woodstock, GA 30189-2600
Phone (678) 490-8176

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110420000563 GA Practitioner - Chiropractic 6103001995 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2010
Medicare assignment
May accept Medicare assignment
Group practices
Cohen Chiropractic CentreGroup PAC ID 3274671730, 2 clinicians

Practice addresses (Care Compare)

1910 Eagle Dr
Suite 100
Woodstock, GA 30189-2600
Phone (678) 490-8176

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIR008789GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Cohen Chiropractic Centre Chiropractor CurrentSince Sep 1, 2020 Accepting new patients

Locations

1910 Eagle Dr
Ste 100
Woodstock, GA 30189
Phone (678) 490-8176

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1301529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533254400000",
    "number": "1548559487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 EAGLE DR STE 100",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301892600",
            "telephone_number": "678-490-8176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 EAGLE DR STE 100",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "30189",
            "telephone_number": "678-490-8176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST. BERNARD",
        "first_name": "ANDREW",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-31",
        "last_updated": "2018-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR008789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.