Active NPI
Bernard Lee Pahl
- Contractor
- Vincent, OH
National Provider Identifier
1700488608
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- WV001686
- Practice address
- 771 Brackenridge Rd
Vincent, OH 45784-5028 - Phone
- (740) 350-8184
- NPI assigned
- Nov 15, 2020
- Last updated
- Nov 15, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | WV001686 | WV | Primary |
Addresses
Primary practice location
771 Brackenridge Rd
Vincent, OH 45784-5028
Mailing address
771 Brackenridge Rd
Vincent, OH 45784-5028
Phone (740) 350-8184
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
| License | State | Type | Specialty |
|---|---|---|---|
| WV001686 | WV | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605398400000",
"number": "1700488608",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "771 BRACKENRIDGE RD",
"city": "VINCENT",
"state": "OH",
"postal_code": "457845028",
"telephone_number": "740-350-8184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "771 BRACKENRIDGE RD",
"city": "VINCENT",
"state": "OH",
"postal_code": "457845028",
"telephone_number": "740-350-8184"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAHL",
"first_name": "BERNARD",
"middle_name": "LEE",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-11-15",
"last_updated": "2020-11-15",
"certification_date": "2020-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "WV",
"license": "WV001686",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vincent, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.