Kelsey Berg, RBT

Key facts

NPI

1104593797

Entity type

Individual (NPI type 1)

Primary specialty

Behavior Technician 106S00000X

Practice address

2850 Universal St
Oshkosh, WI 54904-8975

Phone

(920) 267-8350

NPI assigned

Aug 23, 2021

Sex

Female

Sole proprietor

No

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 and National Provider Directory roles.

• Trio Academy Inc Community/Behavioral Health Agency · Oshkosh, WI · NPI 1720573876
  NPD

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Practice roles

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 23, 2021.

{
    "created_epoch": "1629676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629676800000",
    "number": "1104593797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 UNIVERSAL ST",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549048975",
            "telephone_number": "920-267-8350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 UNIVERSAL ST",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549048975",
            "telephone_number": "920-267-8350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "KELSEY",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-23",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oshkosh, WI

• Scott J Beougher, DO
• Margaret Ann Berdelman, MD
• Sarah Berens, APNP
• John Dennis Berg, CRNA APNP
• Karen Berg
• Timothy Bergan, D.O.
• Brad Weston Berger, R.N.
• Elizabeth Berghammer, ATS
• Kimberly Jean Berndt, M.S., OTR
• Robert L Bernstein, MD

All providers in Oshkosh, WI · Behavior Technician in Wisconsin