Individual provider Active NPI

Julie Lin Berry, M.D.

  • Pediatrics Physician
  • Ogden, UT
National Provider Identifier
1144313438
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
185761-1205 Issued in UT
Practice address
3955 Harrison Blvd
L-1
Ogden, UT 84403-2313
Phone
(801) 621-1701
Fax
(801) 393-9411
NPI assigned
Oct 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 185761-1205 UT Primary

Addresses

Primary practice location

3955 Harrison Blvd
L-1
Ogden, UT 84403-2313

Mailing address

3955 Harrison Blvd
L-1
Ogden, UT 84403-2313
Phone (801) 621-1701

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150515001292 UT Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 4385964261

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
185761-1205UTMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Care of Ogden Pediatrics 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, 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": "1159660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144313438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3955 HARRISON BLVD",
            "address_2": "L-1",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844032313",
            "telephone_number": "801-621-1701",
            "fax_number": "801-393-9411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3955 HARRISON BLVD",
            "address_2": "L-1",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844032313",
            "telephone_number": "801-621-1701",
            "fax_number": "801-393-9411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "JULIE",
        "middle_name": "LIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "UT",
            "license": "185761-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

Verify at the official NPI Registry.