Bernice Janelle Bass, RD,LD/N – Registered Dietitian

Key facts

NPI: 1881868420
Entity type: Individual (NPI type 1)
Primary specialty: Registered Dietitian 133V00000X
License: ND3075 (FL)
Practice address: 2020 E Georgia St
Bartow, FL 33830-6709
Phone: (863) 519-7542
NPI assigned: Apr 15, 2008
Sex: Female
Sole proprietor: No

Organizations & group practices 2

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.

Florida Department of Health Public Health or Welfare Agency · Bronson, FL · NPI 1154395390

NPD (past)
Florida Department of Health Public Health or Welfare Agency · Lakeland, FL · NPI 1396732541

NPD (past)

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
ND3075	FL	MD	Registered Dietitian

Practice roles

Organization	Specialty	Status	New patients
Florida Department of Health		Past	Accepting new patients
Florida Department of Health		Past since Oct 1, 2000	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Registered Dietitian	133V00000X	ND3075	FL	Yes

Addresses

Primary practice location

2020 E Georgia St
Bartow, FL 33830-6709

Mailing address

1290 Golfview Ave
Bartow, FL 33830-6703
Phone (863) 519-7900

Other providers in Bartow, FL

All providers in Bartow, FL · Registered Dietitian in Florida

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 15, 2008. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.