Patricia H Berry, CNP, ACHPN, GNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

5072870-4405 Issued in UT

Practice address

Stellahealth - Livio
401 Harding St NE
Minneapolis, MN 55413

Phone

(612) 398-7000

NPI assigned

Oct 13, 2006

Reactivated

Jun 26, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

State licenses

Practice roles

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.

• Bronson Lakeview Hospital

  • Internal Medicine Physician
  • Paw Paw, MI
  • NPI 1235131137

  Nurse Practitioner

  NPD (past)

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594166400000",
    "number": "1114017746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4517 YORK AVE N",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554221442",
            "telephone_number": "801-243-6444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "STELLAHEALTH - LIVIO",
            "address_2": "401 HARDING ST NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55413",
            "telephone_number": "612-398-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 S 2000 E",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841125880",
            "country_code": "US",
            "telephone_number": "801-585-9636",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERRY",
        "first_name": "PATRICIA",
        "middle_name": "H",
        "credential": "CNP, ACHPN, GNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "deactivation_date": "2020-01-30",
        "reactivation_date": "2020-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "5072870-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kacy Berquist, NP
• Shane B Berquist, L. AC., M.SC.O.M.
• Jill Rose Berray, LGSW
• Cale Berry, D.C.
• Jonathan Miguel Berry, OT
• Ryan Berry
• Shalanda Shawntae Berry, CHW
• Susan Amelia Berry, M.D.
• Christy Berryhill, FNP
• Michael Berryman, MD

• Nurse Practitioner in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2020; 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.