Bernadette Frances Smith, ADULT FOSTER CARE PR

Primary specialty

Assisted Living Facility (Behavioral Disturbances)Taxonomy code 3104A0630X

License

500765185 Issued in OR

Practice address

92158 Cape Arago Hwy,
Coos Bay, OR 97420-8743

Phone

(541) 888-3972

NPI assigned

Aug 28, 2019

Last updated

Aug 28, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Bernadette Frances Weeks Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1566950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566950400000",
    "number": "1598313199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92158 CAPE ARAGO HWY,",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974208743",
            "telephone_number": "541-888-3972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92158 CAPE ARAGO HWY,",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974208743",
            "telephone_number": "541-888-3972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BERNADETTE",
        "middle_name": "FRANCES",
        "name_prefix": "Mrs.",
        "credential": "ADULT FOSTER CARE PR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-28",
        "last_updated": "2019-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": "OR",
            "license": "500765185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BERNADETTE",
            "last_name": "WEEKS",
            "middle_name": "FRANCES",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kiel Lauren Sitter
• Daniel J Skarzynski, M.D.
• Erin Marie Skelton, PA-C
• Kim L Slight, M.D.
• Jonathan Thomas Small, DPT
• Jeanne Smith, LCSW
• Kelly Wayne Smith, NP FNP-PP
• Mandy D. Smith
• Maria Socorro Miel Smith, PT
• Megan Smith, PA-C

• Assisted Living Facility (Behavioral Disturbances) in Coos Bay, OR
• Providers in Coos Bay, OR by specialty
• Assisted Living Facility (Behavioral Disturbances) in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2019; 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.