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Deactivated NPI 1902873268 Deactivated / Inactive NPI Male Practitioner

Shad Theodore Bernard , MA, ATC, L

Specialist • Dayton, OH

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Shad Bernard has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date March 07, 2006
NPI Deactivation Date December 26, 2024
Total Practice Duration ~18 Years of Practice (2006 – 2024)

Professional Overview & Biography Verified Profile Summary

Shad Bernard, MA, ATC, L was a registered Specialist practicing in Dayton, OH. Throughout an active medical career spanning 18 years, Shad Bernard provided care at the practice location at 1997 MIAMISBURG CENTERVILLE RD until profile deactivation on 2024-12-26.

Practice Location & Contact Primary Location

Practice Address

1997 Miamisburg Centerville Rd

Dayton, OH 454593811

Telephone 9374016400
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Dayton, OH

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 36.7 Yrs
State Avg: 37.3 Yrs
Regional Practice Density
55 Specialists

Practicing in Dayton, OH (1444 Statewide)

Telehealth Adoption Rate
1.8% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License OH AT-001528

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

11 Associated Practitioners
Kyle Lipscomb

Specialist/Technologist - Athletic Trainer

NPI 1083073472
Iliniza Imerman

Specialist/Technologist - Athletic Trainer

NPI 1306248224
Rachel Fritz , AT, ATC

Specialist/Technologist - Athletic Trainer

NPI 1396102083

AT, Certified Athletic Trainer

Nikki Bennett , ATC

Specialist/Technologist - Athletic Trainer

NPI 1407114275

Certified Athletic Trainer

Scott Mullett , MA, ATC, LAT

Specialist/Technologist - Athletic Trainer

NPI 1477820108

Master of Arts, Certified Athletic Trainer, Licensed Athletic Trainer

Austin List , AT, ATC, AEMT

Specialist/Technologist - Athletic Trainer

NPI 1609272137

AT, Certified Athletic Trainer, AEMT

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated December 26, 2024

Record deactivated on December 26, 2024

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 1997 MIAMISBURG CENTERVILLE RD, DAYTON, OH 454593811 (Tel: 9374016400)

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Updated Business Mailing Address July 08, 2007

Registered at 5077 TEWKESBURY DR, DAYTON, OH 454243752 (Tel: 9372371018)

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Provider Name / Credentials Updated July 08, 2007

Recorded as SHAD BERNARD, MA, ATC/L

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Specialist (License #AT-001528 in OH)

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Initial NPI Registration & Enumeration March 07, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1902873268
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 07, 2006
Last Update: July 08, 2007
Deactivation Date: December 26, 2024

Mailing Address

5077 Tewkesbury Dr

Dayton, OH 454243752

Phone: 9372371018

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

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