Lisa Loiuse Berry, CHW

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

106730 Issued in OR

Practice address

2206 N Pine St
La Grande, OR 97850-3712

Phone

(541) 323-4676

NPI assigned

Aug 23, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1661212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672099200000",
    "number": "1154040368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "442 SW UMATILLA AVE STE 200",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977567039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2206 N PINE ST",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "978503712",
            "telephone_number": "541-323-4676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "LISA",
        "middle_name": "LOIUSE",
        "credential": "CHW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-23",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "OR",
            "license": "106730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "THW000106730",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Benjamin Michael Bertrand, P.T.
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• Community Health Worker in La Grande, OR
• Providers in La Grande, OR by specialty
• Community Health Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2022; 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.