Jack Edward Berndt

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

Legal business name

JACK EDWARD BERNDT

Practice address

1957 Thompson Rd
Ste. F
Coos Bay, OR 97420-2031

Phone

(541) 808-2392

NPI assigned

Jun 11, 2012

Last updated

Jun 11, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jack Berndt, M.D.

Title

Owner

Phone

(541) 808-2392

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1339372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339372800000",
    "number": "1952663528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1957 THOMPSON RD",
            "address_2": "STE. F",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202031",
            "telephone_number": "541-808-2392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1957 THOMPSON RD",
            "address_2": "STE. F",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202031",
            "telephone_number": "541-808-2392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACK EDWARD BERNDT",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-11",
        "last_updated": "2012-06-11",
        "status": "A",
        "authorized_official_last_name": "BERNDT",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-808-2392",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pain Medicine Physician in Coos Bay, OR
• Providers in Coos Bay, OR by specialty
• Pain Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.