Individual provider Active NPI

Dawn Berry

  • Clinical Psychologist
  • Colorado Springs, CO
National Provider Identifier
1053065227
Registry record updated Feb 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY.0005735 Issued in CO
Practice address
1115 Elkton Dr Ste 102
Colorado Springs, CO 80907-3597
Phone
(719) 357-6471
Fax
(719) 434-9811
NPI assigned
Feb 7, 2022
Last updated
Feb 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY.0005735 CO Primary

Addresses

Primary practice location

1115 Elkton Dr Ste 102
Colorado Springs, CO 80907-3597

Mailing address

1115 Elkton Dr Ste 102
Colorado Springs, CO 80907-3597
Phone (719) 357-6471

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220218000389 CO Practitioner - Clinical Psychologist 1759775661 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1115 Elkton Dr
Suite 102
Colorado Springs, CO 80907-3597
Phone (719) 357-6471

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Springs Psychological Services Clinical CurrentSince Feb 9, 2022 Accepting new patients

Locations

1115 Elkton Dr
Ste 102
Colorado Springs, CO 80907
Phone (719) 357-6471

8380 Zuni St
Ste 305
Westminster, CO 80221
Phone (719) 357-6471

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1644192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644192000000",
    "number": "1053065227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 ELKTON DR STE 102",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809073597",
            "telephone_number": "719-357-6471",
            "fax_number": "719-434-9811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 ELKTON DR STE 102",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809073597",
            "telephone_number": "719-357-6471",
            "fax_number": "719-434-9811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "DAWN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-07",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "PSY.0005735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.