Individual provider Active NPI

Kaitlin E Berry, AUD

  • Audiologist
  • Rockville, MD
National Provider Identifier
1114413028
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
01464 Issued in MD
Practice address
133 Rollins Ave Ste 2
Rockville, MD 20852-4040
Phone
(301) 468-7670
Fax
(301) 468-7620
NPI assigned
Jul 3, 2018
Last updated
Oct 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X MD
Audiologist 231H00000X 01464 MD Primary
Audiologist-Hearing Aid Fitter 237600000X 01464 MD

Addresses

Primary practice location

133 Rollins Ave Ste 2
Rockville, MD 20852-4040

Mailing address

1320 Old Chain Bridge Rd Ste 185
MC Lean, VA 22101-3945
Phone (703) 942-8110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180824001879 DC Practitioner - Qualified Audiologist 9335498245 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centers for Advanced ENT Care LLCGroup PAC ID 1658647359, 103 clinicians

Practice addresses (Care Compare)

6410 Rockledge Dr
Suite 305
Bethesda, MD 20817-1841
Phone (301) 652-8847

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
01464MDMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ear, Nose & Throat Specialists of Shady Grove, P.C. PastSince Jan 1, 2022 Accepting new patients
Cumberland Valley ENT Consultants Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kaitlinberry@sbentc.allscriptsdirect.net
  • Direct secure messaging: kberry798618@direct.hopkinsmedicine.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1530576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1114413028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 OLD CHAIN BRIDGE RD STE 185",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221013945",
            "telephone_number": "703-942-8110",
            "fax_number": "786-907-4485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 ROLLINS AVE STE 2",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524040",
            "telephone_number": "301-468-7670",
            "fax_number": "301-468-7620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "KAITLIN",
        "middle_name": "E",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-03",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MD",
            "license": "01464",
            "primary": true
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "MD",
            "license": "01464",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.