1952397994 NPI number — MR. ANTHONY ROBERT BERNUI PA-C

Table of content: MR. ANTHONY ROBERT BERNUI PA-C (NPI 1952397994)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952397994 NPI number — MR. ANTHONY ROBERT BERNUI PA-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BERNUI
Provider First Name:
ANTHONY
Provider Middle Name:
ROBERT
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
PA-C
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1952397994
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/12/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1310 24TH AVE S
Provider Second Line Business Mailing Address:
SURGICAL SERVICE
Provider Business Mailing Address City Name:
NASHVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37212-2637
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-873-7235
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1310 24TH AVE S
Provider Second Line Business Practice Location Address:
SURGICAL SERVICE
Provider Business Practice Location Address City Name:
NASHVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37212-2637
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-873-7235
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/26/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363A00000X , with the licence number:  PA450 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363AS0400X , with the licence number: PA450 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 4060688 . This is a "BCBS" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 4060688 . This is a "TENNCARE" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 3667115 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1027331 . This is a "NCCPA CERTIFICATION #" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1106613 . This is a "VHP" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".