Individual provider Active NPI

Martha G Berry, APN

  • Family Nurse Practitioner
  • North Little Rock, AR
National Provider Identifier
1073569828
Registry record updated Oct 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A01874 Issued in AR
Practice address
2508 Crestwood Rd
North Little Rock, AR 72116-7623
Phone
(501) 758-2298
Fax
(501) 758-7877
NPI assigned
May 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A01874 AR Primary
Registered Nurse 163W00000X R33544 AR

Addresses

Primary practice location

2508 Crestwood Rd
North Little Rock, AR 72116-7623

Mailing address

11001 Executive Center Dr
Little Rock, AR 72211-4316
Phone (501) 758-2298

Other identifiers 2

IdentifierTypeStateIssuer
492829ZNUDOtherARMEDICARE
189490758MedicaidAR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050816001239 AR Practitioner - Nurse Practitioner 0446280754 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arkansas Health GroupGroup PAC ID 7911802079, 645 clinicians

Practice addresses (Care Compare)

2508 Crestwood Rd
North Little Rock, AR 72116-7623
Phone (501) 758-2294

Hospital & facility affiliations

  • Baptist Health Medical Center-Little Rock Hospital, Little Rock, AR, CCN 040114

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R33544ARMDRegistered Nurse
A01874ARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Health Group CurrentSince Oct 24, 2022 Accepting new patients
Arkansas Health Group CurrentSince Oct 24, 2022 Accepting new patients
Arkansas Cardiology Past Accepting new patients
Cardiovascular Specialty Associates of North Texas, P.a. Past Accepting new patients
Arkansas Health Group Past Accepting new patients

Locations

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

2508 Crestwood Rd
North Little Rock, AR 72116
Phone (501) 758-2294

2900 Hawkins Dr
Searcy, AR 72143
Phone (501) 278-2800

Interoperability endpoints

  • Direct secure messaging: mberry4548@direct.baptist-healthar.org

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1073569828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11001 EXECUTIVE CENTER DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114316",
            "telephone_number": "501-758-2298",
            "fax_number": "501-758-7877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2508 CRESTWOOD RD",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721167623",
            "telephone_number": "501-758-2298",
            "fax_number": "501-758-7877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "MARTHA",
        "middle_name": "G",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-25",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A01874",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AR",
            "license": "R33544",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "492829ZNUD",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "189490758",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Little Rock, AR

Sources for this page

Verify at the official NPI Registry.