Individual provider Active NPI

David Andrew Berry Jr., D.C.

  • Chiropractor
  • Seymour, TN
National Provider Identifier
1023145547
Registry record updated Oct 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC0000001769 Issued in TN
Practice address
119 Maryville Hwy
Suite a
Seymour, TN 37865-5901
Phone
(865) 573-1234
Fax
(865) 573-3322
NPI assigned
Feb 28, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC0000001769 TN Primary
Chiropractor 111N00000X 1769 TN

Addresses

Primary practice location

119 Maryville Hwy
Suite a
Seymour, TN 37865-5901

Mailing address

119 Maryville Hwy
Suite a
Seymour, TN 37865-5901
Phone (865) 573-1234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050601001047 TN Practitioner - Chiropractic 4082656970 Practice locations: Seymour, TN

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2000
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

119 A Maryville Hwy
Seymour, TN 37865-5901

119 Maryville Hwy
Suite a
Seymour, TN 37865-5901

119 Maryville Hwy a
Seymour, TN 37865-5901
Phone (865) 573-1234

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC0000001769TNMDChiropractor
1769TNMDAudiologist

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444694400000",
    "number": "1023145547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 MARYVILLE HWY",
            "address_2": "SUITE A",
            "city": "SEYMOUR",
            "state": "TN",
            "postal_code": "378655901",
            "telephone_number": "865-573-1234",
            "fax_number": "865-573-3322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 MARYVILLE HWY",
            "address_2": "SUITE A",
            "city": "SEYMOUR",
            "state": "TN",
            "postal_code": "378655901",
            "telephone_number": "865-573-1234",
            "fax_number": "865-573-3322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "DAVID",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2015-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "DC0000001769",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "1769",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seymour, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.