Bernadette K Sobczak, DNP, APRN, CPNP-PC,

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

209-007531 Issued in IL

Practice address

3030 Frank Scott Parkway West
Suite 1
Belleville, IL 62223-5014

Phone

(618) 257-2550

Fax

(618) 257-2569

NPI assigned

Apr 22, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Bernadette Kathlene Mordis Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• David C. Norman MD Inc

  • Pediatric Adolescent Medicine Physician
  • Belleville, IL
  • NPI 1841475746
  NPD (past)

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

{
    "created_epoch": "1240358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1649414558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 FRANK SCOTT PARKWAY WEST",
            "address_2": "SUITE 1",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622235014",
            "telephone_number": "618-257-2550",
            "fax_number": "618-257-2569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 FRANK SCOTT PARKWAY WEST",
            "address_2": "SUITE 1",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622235014",
            "telephone_number": "618-257-2550",
            "fax_number": "618-257-2569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOBCZAK",
        "first_name": "BERNADETTE",
        "middle_name": "K",
        "name_prefix": "Mrs.",
        "credential": "DNP, APRN, CPNP-PC,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-22",
        "last_updated": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IL",
            "license": "209-007531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209-007531",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BERNADETTE",
            "last_name": "MORDIS",
            "middle_name": "KATHLENE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Thomas Hamilton Smith, M.D.
• Jaclyn N Sneed, PA
• Robert Joseph Snider
• Eric Snook, D.P.M.
• Karen M Snyder, COTA
• Brett Alan Sobieralski, O.D.
• Someone Special Home Care LLC
• Soothing Souls Therapeutic Services, LLC
• South Central Anesthesia LTD
• Southern Illinois Endoscopy

• Pediatric Nurse Practitioner in Belleville, IL
• Providers in Belleville, IL by specialty
• Pediatric Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; 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.