Individual provider Active NPI

Judith Berthaud

  • Gerontology Registered Nurse
  • Brentwood, TN
National Provider Identifier
1073994125
Registry record updated Jun 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Registered NurseTaxonomy code 163WG0600X
License
RN0000131939 Issued in TN
Practice address
5920 River Oaks Rd
Brentwood, TN 37027-4024
Phone
(615) 934-2072
NPI assigned
Jun 15, 2015
Last updated
Jun 15, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X RN0000131939 TX
Gerontology Registered Nurse 163WG0600X RN0000131939 TN Primary
Home Health Registered Nurse 163WH0200X RN0000131939 TN
Hospice Registered Nurse 163WH1000X RN0000131939 TN

Addresses

Primary practice location

5920 River Oaks Rd
Brentwood, TN 37027-4024

Mailing address

5920 River Oaks Rd
Brentwood, TN 37027-4024

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RN0000131939TXMDCommunity Health Registered Nurse
RN0000131939TNMDHospice Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Surecare Nursing Past Accepting new patients

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": "1434326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434326400000",
    "number": "1073994125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5920 RIVER OAKS RD",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5920 RIVER OAKS RD",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274024",
            "telephone_number": "615-934-2072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTHAUD",
        "first_name": "JUDITH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-15",
        "last_updated": "2015-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "TX",
            "license": "RN0000131939",
            "primary": false
        },
        {
            "code": "163WG0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gerontology",
            "state": "TN",
            "license": "RN0000131939",
            "primary": true
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "TN",
            "license": "RN0000131939",
            "primary": false
        },
        {
            "code": "163WH1000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Hospice",
            "state": "TN",
            "license": "RN0000131939",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2015; 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.