Individual provider Active NPI

Michelle Bernard

  • Registered Dietitian
  • Allentown, PA
National Provider Identifier
1902534787
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DN002739 Issued in PA
Practice address
1210 S Cedar Crest Blvd
Allentown, PA 18103-6229
Phone
(610) 402-3866
Fax
(610) 402-3859
NPI assigned
Aug 10, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DN002739 PA Primary

Addresses

Primary practice location

1210 S Cedar Crest Blvd
Allentown, PA 18103-6229

Mailing address

2100 Mack Blvd FL 4
Allentown, PA 18103-5622
Phone (484) 330-1377

Other identifiers 1

IdentifierTypeStateIssuer
DN002739OtherPASTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221028000821 PA Practitioner - Registered Dietitian Or Nutrition Professional 5698142073 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN002739PAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group Current Accepting new patients
Lehigh Valley Physician Group CurrentSince Oct 6, 2022 Accepting new patients
Lehigh Valley Physician Group CurrentSince Oct 6, 2022 Accepting new patients

Locations

1210 S Cedar Crest Blvd
Allentown, PA 18103
Phone (610) 402-1150

2100 Mack Blvd
Fl 2
Allentown, PA 18103

1243 S Cedar Crest Blvd
Ste 2200
Allentown, PA 18103
Phone (610) 402-2500

2100 Mack Blvd
Fl 4
Allentown, PA 18103

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1660089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1902534787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 MACK BLVD FL 4",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181035622",
            "telephone_number": "484-330-1377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 S CEDAR CREST BLVD",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036229",
            "telephone_number": "610-402-3866",
            "fax_number": "610-402-3859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNARD",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-10",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN002739",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "DN002739",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.