Individual provider Active NPI

Pamela Gail Bedard, MSW

  • Case Manager/Care Coordinator
  • Daytona Beach, FL
National Provider Identifier
1699745620
Registry record updated May 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
1220 Willis Ave
Daytona Beach, FL 32114-2810
Phone
(386) 236-1669
NPI assigned
Jan 24, 2006
Last updated
May 21, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Case Manager/Care Coordinator 171M00000X NU Primary

Addresses

Primary practice location

1220 Willis Ave
Daytona Beach, FL 32114-2810

Mailing address

2943 Oak Lea Dr
South Daytona, FL 32119-3225
Phone (386) 760-1065

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

NPI Registry JSON

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337558400000",
    "number": "1699745620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2943 OAK LEA DR",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321193225",
            "telephone_number": "386-760-1065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 WILLIS AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142810",
            "telephone_number": "386-236-1669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEDARD",
        "first_name": "PAMELA",
        "middle_name": "GAIL",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-24",
        "last_updated": "2012-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2012; 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.