John Berry Jr., MD

Individual provider Active NPI Surgery Physician · Kinston, NC

NPI 1003857772 · NPPES record last updated Jun 29, 2010

Key facts

NPI
1003857772
Entity type
Individual (NPI type 1)
Primary specialty
Surgery Physician 208600000X
License
28128 (NC)
Practice address
701 Doctors Dr
Suite a
Kinston, NC 28501-1589
Phone
(252) 522-1626
Fax
(252) 522-1486
NPI assigned
Jun 10, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
28128NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Kinston Surgical Associates PA Surgery Current
since Jun 24, 1994
Accepting new patients
Interventional Pain & Spine Specialists, PLLC Past Accepting new patients

Locations

701 Doctors Dr
Ste A
Kinston, NC 28501
Phone (252) 522-1626

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/6303/brand/1/csg/1/fhir/r4

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 28128 NC Yes

Addresses

Primary practice location

701 Doctors Dr
Suite a
Kinston, NC 28501-1589

Mailing address

PO Box 1316
Kinston, NC 28503
Phone (252) 522-1626

Other identifiers

IdentifierTypeStateIssuer
8915186MedicaidNC

Other providers in Kinston, NC

All providers in Kinston, NC · Surgery Physician in North Carolina

Sources for this page

Verify at the official NPI Registry.