Basic Information
| Provider Information | |||||||||
| NPI: | 1245234814 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BERNING | ||||||||
| FirstName: | LENORA | ||||||||
| MiddleName: | W. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1420 E 7TH ST | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282042408 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7043750100 | ||||||||
| FaxNumber: | 7048876450 | ||||||||
| Practice Location | |||||||||
| Address1: | 1420 E 7TH ST | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282042408 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7043750100 | ||||||||
| FaxNumber: | 7048876450 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/10/2005 | ||||||||
| LastUpdateDate: | 03/02/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | MD054526L | PA | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 34251 | NC | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207QH0002X | 34251 | NC | Y | Allopathic & Osteopathic Physicians | Family Medicine | Hospice and Palliative Medicine |
ID Information
| ID | Type | State | Issuer | Description | 011496469 | 05 | PA | MEDICAID | 144AE | 01 | NC | BCBSNC | OTHER | 59-06771 | 05 | NC | MEDICAID | P00364545 | 01 | NC | RR MEDICARE | OTHER | 157145 | 05 | SC | MEDICAID |