Active NPI
Berry Best Mobile Lab Services, LLC
- Clinical Medical Laboratory
- Tucson, AZ
National Provider Identifier
1154078541
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- Legal business name
- BERRY BEST MOBILE LAB SERVICES, LLC
- Practice address
- 325 W 2ND St BLDG 2
Ste 108
Tucson, AZ 85705 - Phone
- (954) 822-4722
- Fax
- (866) 420-8579
- NPI assigned
- Mar 4, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kelly Monique Ellsberry, CPT
- Title
- Founder/ Head Lab Technician
- Phone
- (954) 822-4722
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | Primary |
Addresses
Primary practice location
325 W 2ND St BLDG 2
Ste 108
Tucson, AZ 85705
Mailing address
PO Box 18641
Tucson, AZ 85731-8641
Phone (954) 822-4722
Other practice location 1
40 N Swan Rd Ste 45
Tucson, AZ 85711-3052
Phone (954) 822-4722
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Virtru | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220518000101 | AZ | Part B Supplier - Independent Clinical Laboratory | 0446637276 | Practice locations: Tucson, AZ |
National Provider Directory
National Provider DirectoryLocations
325 W 2nd St
Bldg 2
Tucson, AZ 85705
Phone (520) 325-9060
40 N Swan Rd
Ste 45
Tucson, AZ 85711
Phone (520) 325-9060
Ownership & related parties
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
-
- Health Educator
- Tucson, AZ
- NPI 1598412983
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1646352000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1662508800000",
"number": "1154078541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 18641",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857318641",
"telephone_number": "954-822-4722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "325 W 2ND ST BLDG 2",
"address_2": "STE 108",
"city": "TUCSON",
"state": "AZ",
"postal_code": "85705",
"telephone_number": "954-822-4722",
"fax_number": "866-420-8579"
}
],
"practiceLocations": [
{
"address_1": "40 N Swan Rd Ste 45",
"address_purpose": "LOCATION",
"city": "Tucson",
"state": "AZ",
"postal_code": "857113052",
"country_code": "US",
"telephone_number": "954-822-4722",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "BERRY BEST MOBILE LAB SERVICES, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-03-04",
"last_updated": "2022-09-07",
"certification_date": "2022-09-07",
"status": "A",
"authorized_official_last_name": "ELLSBERRY",
"authorized_official_first_name": "KELLY",
"authorized_official_middle_name": "MONIQUE",
"authorized_official_title_or_position": "FOUNDER/ HEAD LAB TECHNICIAN",
"authorized_official_telephone_number": "954-822-4722",
"authorized_official_credential": "CPT"
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Virtru",
"affiliation": "N",
"endpointDescription": "Virtru encryption email service",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "325 W 2nd St Bldg 2",
"address_2": "Ste 108",
"city": "Tucson",
"state": "AZ",
"country_code": "US",
"postal_code": "85705",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.