Basic Information
Provider Information | |||||||||
NPI: | 1689698813 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | BIERMAN-DEAR | ||||||||
FirstName: | NANCY | ||||||||
MiddleName: | A. | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | DEAR | ||||||||
OtherFirstName: | NANCY | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: | M.D. | ||||||||
OtherLastNameType: | 1 | ||||||||
Mailing Information | |||||||||
Address1: | 5000 COX RD | ||||||||
Address2: |   | ||||||||
City: | GLEN ALLEN | ||||||||
State: | VA | ||||||||
PostalCode: | 230609263 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8049685700 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 630 MANTUA PIKE | ||||||||
Address2: |   | ||||||||
City: | WOODBURY | ||||||||
State: | NJ | ||||||||
PostalCode: | 080963233 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8568122220 | ||||||||
FaxNumber: |   | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 07/27/2006 | ||||||||
LastUpdateDate: | 02/11/2021 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 02/11/2021 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | D0089814 | MD | N |   | Allopathic & Osteopathic Physicians | Family Medicine |   | 207Q00000X | 0101270230 | VA | N |   | Allopathic & Osteopathic Physicians | Family Medicine |   | 207Q00000X | 25MA05361400 | NJ | Y |   | Allopathic & Osteopathic Physicians | Family Medicine |   |
ID Information
ID | Type | State | Issuer | Description | 0513488000 | 01 |   | AMERIHEALTH HMO | OTHER | K4942 | 01 | NJ | HORIZON | OTHER | 679434 | 01 | NJ | AMERIHEALTH PPO | OTHER | 4581407 | 05 | NJ |   | MEDICAID | 1156257 | 01 | NJ | HORIZON MERCY | OTHER | 221820210 | 01 | NJ | UNITED HEALTHCARE | OTHER | 01000218301 | 01 | NJ | AMERICHOICE | OTHER | 1K9950 | 01 | NJ | HEALTH NET | OTHER | 221820210 | 01 | NJ | ATLANTICARE HMO/PPO | OTHER | 3217 | 01 |   | AETNA | OTHER |