R Dale Bernauer MD Apmc

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

04478R Issued in LA

Legal business name

R DALE BERNAUER MD APMC

Practice address

4150 Nelson Rd
BLDG D Ste 1
Lake Charles, LA 70605

Phone

(337) 474-6960

Fax

(337) 474-6970

NPI assigned

Jul 18, 2008

Organization subpart

No

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

Authorized official

Name

Lisa E Ewing

Title

Office Manager

Phone

(667) 474-6960

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Bernauer Clinic Other name

Locations

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

{
    "created_epoch": "1216339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237334400000",
    "number": "1639333628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 NELSON RD",
            "address_2": "BLDG D STE 1",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "70605",
            "telephone_number": "337-474-6960",
            "fax_number": "337-474-6970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 NELSON RD",
            "address_2": "BLDG D STE 1",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "70605",
            "telephone_number": "337-474-6960",
            "fax_number": "337-474-6970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R DALE BERNAUER MD APMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-18",
        "last_updated": "2009-03-18",
        "status": "A",
        "authorized_official_last_name": "EWING",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "667-474-6960"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "LA",
            "license": "04478R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1966789",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1192805",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bernauer Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Orthopaedic Surgery Physician in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• Orthopaedic Surgery Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2009; 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.