Individual provider Active NPI

Linda Berg-Cross

  • Psychologist
  • Potomac, MD
National Provider Identifier
1114079969
Registry record updated Jun 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
01271 Issued in MD
Practice address
13 Atwell CT
Potomac, MD 20854-6235
Phone
(301) 762-5441
Fax
(301) 762-5441
NPI assigned
Jan 18, 2007
Last updated
Jun 22, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 01271 MD Primary
Psychologist 103T00000X 1212 DC

Addresses

Primary practice location

13 Atwell CT
Potomac, MD 20854-6235

Mailing address

13 Atwell CT
Potomac, MD 20854-6235
Phone (301) 762-5441

Other identifiers 2

IdentifierTypeStateIssuer
41085801OtherMDBC/BS
S062-0344OtherMDBC/BS REGIONAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160121000042 DC Practitioner - Clinical Psychologist 6305900887 Practice locations: Potomac, MD

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1974
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

13 Atwell CT
Potomac, MD 20854-6235
Phone (301) 762-5441

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1212DCMDPsychologist
01271MDMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245628800000",
    "number": "1114079969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 ATWELL CT",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "208546235",
            "telephone_number": "301-762-5441",
            "fax_number": "301-762-5441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 ATWELL CT",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "208546235",
            "telephone_number": "301-762-5441",
            "fax_number": "301-762-5441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG-CROSS",
        "first_name": "LINDA",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2009-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "01271",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "DC",
            "license": "1212",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "41085801",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS REGIONAL",
            "identifier": "S062-0344",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Potomac, MD

Sources for this page

Verify at the official NPI Registry.