Patricia Berry, RD,LD,CDE

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DT83283 Issued in TX

Practice address

12526 High Bluff Dr Ste 300
San Diego, CA 92130-2067

Phone

(512) 375-3210

Fax

(858) 205-1430

NPI assigned

Dec 23, 2014

Last updated

Sep 27, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Back in Action Physical Therapy Inc.

  • Physical Therapist
  • San Diego, CA
  • NPI 1497053318
  NPD (past)

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

{
    "created_epoch": "1419292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1104214311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12865 CAMINITO DEL CANTO",
            "city": "DEL MAR",
            "state": "CA",
            "postal_code": "920143758",
            "telephone_number": "858-472-2184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12526 HIGH BLUFF DR STE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921302067",
            "telephone_number": "512-375-3210",
            "fax_number": "858-205-1430"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7500 Rialto Blvd",
            "address_2": "Bldg 1, Ste 250",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "78735",
            "country_code": "US",
            "telephone_number": "512-375-3210",
            "fax_number": "858-205-1430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERRY",
        "first_name": "PATRICIA",
        "credential": "RD,LD,CDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-23",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT83283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "387305ZG8J",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carolyn Berry
• Hannah Muldoon Berry
• James B Berry
• James Michael Berry, MD
• Meghan Elizabeth Berry, PA
• Patsy Berry, RN, BSN, CLNC
• Steven Major Berry, RADT
• Susan Elizabeth Berry, MS
• William Robert Berry, MD
• Zoe Berry, MSW

• Registered Dietitian in San Diego, CA
• Providers in San Diego, CA by specialty
• Registered Dietitian in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; 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.