Individual provider Active NPI

Bernadette Sharon Hunter, LPN

  • Licensed Practical Nurse
  • Fort Gordon, GA
National Provider Identifier
1689831273
Registry record updated Aug 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LPN044950 Issued in GA
Practice address
B Street BLDG 29709
Connelly Health Clinic Attn Ddeamc
Ft Gordon, GA 30905-5650
Phone
(706) 787-5174
Fax
(706) 787-5145
NPI assigned
May 21, 2008
Last updated
Aug 28, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LPN044950 GA Primary

Addresses

Primary practice location

B Street BLDG 29709
Connelly Health Clinic Attn Ddeamc
Ft Gordon, GA 30905-5650

Mailing address

B Street BLDG 29709
Connelly Health Clinic Attn Ddeamc
Ft Gordon, GA 30905-5650
Phone (706) 787-5174

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPN044950GAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219881600000",
    "number": "1689831273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "B STREET BLDG 29709",
            "address_2": "CONNELLY HEALTH CLINIC ATTN DDEAMC",
            "city": "FT GORDON",
            "state": "GA",
            "postal_code": "309055650",
            "telephone_number": "706-787-5174",
            "fax_number": "706-787-5145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "B STREET BLDG 29709",
            "address_2": "CONNELLY HEALTH CLINIC ATTN DDEAMC",
            "city": "FT GORDON",
            "state": "GA",
            "postal_code": "309055650",
            "telephone_number": "706-787-5174",
            "fax_number": "706-787-5145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUNTER",
        "first_name": "BERNADETTE",
        "middle_name": "SHARON",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-21",
        "last_updated": "2008-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "LPN044950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Gordon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2008; 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.