BERNARD A. TISDALE, M.D., P.C (NPI# 1215030416) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215030416 |
| Entity Type | Organization |
| Organization Name | BERNARD A. TISDALE, M.D., P.C |
| Practice Address |
1109 W Marshall St Richmond VA 23220-3835 |
| Practice Telephone | 8042577337 |
| Mailing Telephone | 8042577337 |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. BERNARD A TISDALE (PHYSICIAN) |
| Authorized Official Telephone | 8042577337 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | VA | Other Service Providers |
| Street Address |
1109 W MARSHALL ST |
| City | RICHMOND |
| State | VA |
| Zip Code | 23220-3835 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124009600 | Bernard Alvan Tisdale | Radiology | 1109 W Marshall St, Richmond, VA 23220-3835 | 2005-11-10 |
| 1063734390 | Central Virginia Associates of Surgery LLC | Surgery | 1109 W Marshall St, Richmond, VA 23220-3835 | 2010-03-01 |
| 1083725527 | Kenneth R. Foxx | Surgery | 1109 W Marshall St, Richmond, VA 23220-3835 | 2006-08-31 |
| 1467438515 | Commonwealth Cancer Institute | Radiology | 1109 W Marshall St, Richmond, VA 23220-3835 | 2005-12-21 |
| 1669456570 | Marcus Wendell Brown | Radiology | 1109 W Marshall St, Richmond, VA 23220-3835 | 2005-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538637855 | Lindsay Kruger | Health Educator | 2 W Franklin Street, Richmond, VA 23220 | 2018-11-05 |
| 1578045993 | Lauren Jernegan | Physician Assistant | 204 S Mulberry St, Richmond, VA 23220 | 2018-09-01 |
| 1699266312 | Madhura Vikas Chitnavis | Student in an Organized Health Care Education/Training Program | Vcuhs Dept of Radiology, 980615, 1250 E Marshall St, Richmond, VA 23220 | 2018-05-29 |
| 1457842759 | Alfred Vann II | Social Worker | 119 W. Leigh St., Richmond, VA 23220 | 2018-05-22 |
| 1598269193 | Lilah Sol | Health Educator | Ymca, 2 W Franklin St., Richmond, VA 23220 | 2018-03-20 |
| 1568965531 | Anne Danforth | Health Educator | 2 West Franklin Street, Downtown Ymca, Richmond, VA 23220 | 2018-03-15 |
| 1154840791 | Constant Change Enterprises LLC | Counselor | 1805 Monument Avenue, Suite 208, Richmond, VA 23220 | 2017-09-14 |
| 1023534393 | Diane H Brown | Social Worker | 2106 Rosewood Avenue, Richmond, VA 23220 | 2017-08-18 |
| 1831624295 | Trent Roubleau | Student in an Organized Health Care Education/Training Program | 2114 Maplewood Ave, Richmond, VA 23220 | 2017-04-24 |
| 1679013312 | Blair Fine | Social Worker | 2117 West Main Street, Richmond, VA 23220 | 2017-02-28 |
| Find all providers in zip 23220 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407382948 | Bharti Mehta | Specialist | 9609 Gayton Rd Ste 102, Richmond, VA 23238-4900 | 2017-05-03 |
| 1912454265 | Ivan Tolbert | Specialist | 1702 Dakota Ave, Richmond, VA 23220-6911 | 2016-09-03 |
| 1447608625 | Lorraine Closser | Specialist | 68753 S Main St, Richmond, MI 48062-1209 | 2016-05-29 |
| 1992173561 | Paige Weekes | Specialist | 3200 Manorcrest Rd, Richmond, VA 23234-2335 | 2015-09-12 |
| 1396123519 | Lori Dotson | Specialist | 401 Lewis Dr, Richmond, KY 40475-7723 | 2015-05-07 |
| 1174929178 | Sonya Seng | Specialist | 5500 Monument Ave Ste M, Richmond, VA 23226-1452 | 2014-11-18 |
| 1568881837 | Adaugo Amuta | Specialist | 19515 Stetson Heights Ln, Richmond, TX 77407-5583 | 2014-04-15 |
| 1306277983 | Tabitha Ames | Specialist | 3748 Morningside Dr, Richmond, CA 94803-2128 | 2013-12-06 |
| 1659705945 | Emily Sarah Bracy | Specialist | 1310 Gilchrist Ct, Richmond, VA 23231-5110 | 2013-08-22 |
| 1386076206 | Marcia Elizabeth Logan | Specialist | 25543 Canyon Crossing Dr, Richmond, TX 77406-7278 | 2013-08-01 |
| Find all providers in RICHMOND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.