Individual provider Active NPI

Kerry Ellis-Berry, A.R.N.P

  • Psychiatric/Mental Health Nurse Practitioner
  • Fort Myers, FL
National Provider Identifier
1124420716
Registry record updated Sep 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
ARNP2923672 Issued in FL
Practice address
14271 Metropolis Ave
Suite a
Fort Myers, FL 33912
Phone
(239) 939-7777
Fax
(239) 936-0036
NPI assigned
Sep 25, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X ARNP2923672 FL Primary

Addresses

Primary practice location

14271 Metropolis Ave
Suite a
Fort Myers, FL 33912

Mailing address

14271 Metropolis Ave
Suite a
Fort Myers, FL 33912
Phone (239) 939-7777

Other names 1

  • Ms. Kerry Ellis Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
ARNP2923672FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Neuropsychiatric Research Center of Southwest Florida LLC Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1411603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411603200000",
    "number": "1124420716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14271 METROPOLIS AVE",
            "address_2": "SUITE A",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "33912",
            "telephone_number": "239-939-7777",
            "fax_number": "239-936-0036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14271 METROPOLIS AVE",
            "address_2": "SUITE A",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "33912",
            "telephone_number": "239-939-7777",
            "fax_number": "239-936-0036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS-BERRY",
        "first_name": "KERRY",
        "name_prefix": "Mrs.",
        "credential": "A.R.N.P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-25",
        "last_updated": "2014-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "ARNP2923672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KERRY",
            "last_name": "ELLIS",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2014; 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.