Individual provider Active NPI

Andrew Carl Bernhard, MA, CCC-SLP

  • Speech-Language Pathologist
  • Vancouver, WA
National Provider Identifier
1689187619
Registry record updated Dec 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
LL60952061 Issued in WA
Practice address
13413 NE Leroy Hagen Memorial Dr
Vancouver, WA 98684-5967
Phone
(360) 604-4000
NPI assigned
Nov 13, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 016483 OR
Speech-Language Pathologist 235Z00000X 25755 CA
Speech-Language Pathologist 235Z00000X 6661 MT
Speech-Language Pathologist 235Z00000X LL60952061 WA Primary

Addresses

Primary practice location

13413 NE Leroy Hagen Memorial Dr
Vancouver, WA 98684-5967

Mailing address

1221 NE 125TH Ave
Vancouver, WA 98684-5725
Phone (971) 386-3030

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL IEP Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230727000025 WA Practitioner - Qualified Speech Language Pathologist 0840651717

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
6661MTMDSpecialist
016483ORMDSpeech-Language Pathologist
LL60952061WAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Open Pathway Speech-Language Therapy, LLC Speech-Language Pathologist CurrentSince Dec 26, 2021 Accepting new patients

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": "1510531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640131200000",
    "number": "1689187619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 NE 125TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986845725",
            "telephone_number": "971-386-3030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13413 NE LEROY HAGEN MEMORIAL DR",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986845967",
            "telephone_number": "360-604-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNHARD",
        "first_name": "ANDREW",
        "middle_name": "CARL",
        "name_prefix": "Mr.",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-13",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OR",
            "license": "016483",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "25755",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MT",
            "license": "6661",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL60952061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "IEP",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "13413 NE LeRoy Hagen Memorial Dr",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986845967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.