Active NPI
Kerry Ellis-Berry, A.R.N.P
- Psychiatric/Mental Health Nurse Practitioner
- Fort Myers, FL
National Provider Identifier
1124420716
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- ARNP2923672
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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
| License | State | Type | Specialty |
|---|---|---|---|
| ARNP2923672 | FL | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Psychiatry Physician
- Fort Myers, FL
- NPI 1013118041
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.