Theresa Kimberley Malmon-Berg, M.S.N., C.N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP05937 Issued in OH

Practice address

1740 Cleveland Rd
Wooster, OH 44691-2204

Phone

(330) 287-4500

NPI assigned

May 2, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Master of Science - Nursing

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248652800000",
    "number": "1013139021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 FOREST DR.",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "44691",
            "telephone_number": "330-262-4501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 CLEVELAND RD",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446912204",
            "telephone_number": "330-287-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALMON-BERG",
        "first_name": "THERESA",
        "middle_name": "KIMBERLEY",
        "name_prefix": "Ms.",
        "credential": "M.S.N., C.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2009-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "NP05937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gitanjali Malapatti
• John J Malgieri, MD
• Stephen John Malich, MS
• Bilal Malik, MD
• Leann Frances Mallernee, MSW, LISW-S
• Desiree Charlotte Malson
• Lisa A Malys, DO
• Lisa J Mangiardi
• Fatimah Renee Manjaroe
• Stephen F Mankins, PT, DPT

• Family Nurse Practitioner in Wooster, OH
• Providers in Wooster, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.