Kelly Johnson Berry, PT, MPH

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1968 Issued in OK

Practice address

12697 E 51St St
Tulsa, OK 74146-6236

Phone

(918) 744-2476

NPI assigned

Jun 2, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1622592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1144896804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1923 S UTICA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741046520",
            "telephone_number": "918-744-2476",
            "fax_number": "918-744-3075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12697 E 51ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741466236",
            "telephone_number": "918-744-2476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "KELLY",
        "middle_name": "JOHNSON",
        "name_prefix": "Mrs.",
        "credential": "PT, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-02",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "1968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alicia Berry, LAT, ATC
• Cherelle Berry
• Cynthia Mae Berry, D.O.
• Douglas B Berry
• Katelyn Jynx Berry
• Lisa Michelle Berry
• Michael Berry
• Phillip Ray Berry, D.O.
• Rachel Ann Berry, LMSW
• Shakeia Lashae Berry

• Physical Therapist in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Physical Therapist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; 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.