Active NPI
Samuel Terrell Bernard, CSFA
- Surgical Assistant
- Pinellas Park, FL
National Provider Identifier
1780924258
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- License
- 139299
- Practice address
- 7048 69TH St N
Pinellas Park, FL 33781-3930 - Phone
- (727) 417-0355
- NPI assigned
- Feb 21, 2013
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | 139299 | Primary |
Addresses
Primary practice location
7048 69TH St N
Pinellas Park, FL 33781-3930
Mailing address
PO Box 2814
Pinellas Park, FL 33780-2814
Phone (727) 417-0355
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": "1361404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361404800000",
"number": "1780924258",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2814",
"city": "PINELLAS PARK",
"state": "FL",
"postal_code": "337802814",
"telephone_number": "727-417-0355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7048 69TH ST N",
"city": "PINELLAS PARK",
"state": "FL",
"postal_code": "337813930",
"telephone_number": "727-417-0355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERNARD",
"first_name": "SAMUEL",
"middle_name": "TERRELL",
"name_prefix": "Mr.",
"credential": "CSFA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-02-21",
"last_updated": "2013-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": null,
"license": "139299",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pinellas Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.