NPIMap

Individual provider Active NPI

Michael P Berry, M.D.

  • Family Medicine Physician
  • North Little Rock, AR
National Provider Identifier
1093813644
Registry record updated May 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E-3756 Issued in AR
Practice address
2508 Crestwood Rd
North Little Rock, AR 72116-7623
Phone
(501) 758-2294
Fax
(501) 758-7877
NPI assigned
Sep 20, 2006
Last updated
May 21, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E-3756 AR Primary

Addresses

Primary practice location

2508 Crestwood Rd
North Little Rock, AR 72116-7623

Mailing address

904 Autumn Rd Ste 500
Little Rock, AR 72211-3738

Other identifiers 4

IdentifierTypeStateIssuer
150346001MedicaidAR
652505OtherARHEALTHLINK
04020016100OtherARQUALCHOICE
7867477OtherARAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071023000436 AR Practitioner - Family Practice 6305932229 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fands Physical Therapy, IncGroup PAC ID 7810898459, 217 clinicians
Arkansas Health GroupGroup PAC ID 7911802079, 645 clinicians

Practice addresses (Care Compare)

1414 Hwy 71 N
Alma, AR 72921-4723
Phone (479) 632-0321

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

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E-3756ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Health Group Family Medicine Current Accepting new patients
Arkansas Health Group Family Medicine CurrentSince Sep 1, 2010 Accepting new patients
Arkansas Health Group CurrentSince Sep 1, 2010 Accepting new patients
Arkansas Health Group Family Medicine Past Accepting new patients
Ozarks Medical Center Family Medicine 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

Interoperability endpoints

  • Direct secure messaging: mberry3983@direct.baptist-healthar.org

Organizations & group practices 6

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.

Hospital & facility affiliations 7

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211328000000",
    "number": "1093813644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 AUTUMN RD STE 500",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722113738"
        },
        {
            "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": "501-758-2294",
            "fax_number": "501-758-7877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "MICHAEL",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2008-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-3756",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150346001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "652505",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE",
            "identifier": "04020016100",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7867477",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Little Rock, AR

Sources for this page

Verify at the official NPI Registry.