Individual provider Active NPI

Caleb James Berg, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1144908328
Registry record updated Sep 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2023033096 Issued in MO
Practice address
3905 Botanical Ave Apt B
Saint Louis, MO 63110-4054
Phone
(618) 623-6661
NPI assigned
Jul 7, 2023
Last updated
Sep 15, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2026

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 2023033096 MO Primary

Addresses

Primary practice location

3905 Botanical Ave Apt B
Saint Louis, MO 63110-4054

Mailing address

3905 Botanical Ave Apt B
Saint Louis, MO 63110-4054
Phone (618) 623-6661

Other practice location 1

10004 Kennerly Rd Ste 362B
Saint Louis, MO 63128-2178
Phone (314) 525-5050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231010001041 MO Practitioner - Nurse Practitioner 1456706548 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community and Long-Term Care Psychiatry LLCGroup PAC ID 4486949773, 14 clinicians

Practice addresses (Care Compare)

10004 Kennerly Rd
Suite 362B
Saint Louis, MO 63128-2178
Phone (314) 525-5050

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.86 of 100Reported as group
Quality
70.88
Promoting interoperability
100
Improvement activities
40
Cost
82.7

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2023033096MOMDPsychiatric/Mental Health Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: caleb.berg.1@20454.direct.athenahealth.com
  • Direct secure messaging: cberg396265@direct-ehr-ssmhc.com

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1688688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789430400000",
    "number": "1144908328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3905 BOTANICAL AVE APT B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631104054",
            "telephone_number": "618-623-6661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3905 BOTANICAL AVE APT B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631104054",
            "telephone_number": "618-623-6661"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10004 Kennerly Rd Ste 362B",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631282178",
            "country_code": "US",
            "telephone_number": "314-525-5050",
            "fax_number": "314-525-5072",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERG",
        "first_name": "CALEB",
        "middle_name": "JAMES",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-07",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2023033096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.