NPIMap

Individual provider Active NPI

Ralph Roger Berg Jr., M.D.

  • Psychiatry Physician
  • Goldsboro, NC
National Provider Identifier
1154335511
Registry record updated May 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
33613 Issued in NC
Practice address
1503 Wayne Memorial Dr
Suite H
Goldsboro, NC 27534-2203
Phone
(919) 330-4367
Fax
(919) 330-4375
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 33613 NC Primary

Addresses

Primary practice location

1503 Wayne Memorial Dr
Suite H
Goldsboro, NC 27534-2203

Mailing address

1503 Wayne Memorial Dr
Suite H
Goldsboro, NC 27534-2203
Phone (919) 330-4367

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Alternative Care Treatments Systems, Inc Past Accepting new patients
Wayne Cares Inc. PastSince Dec 25, 2012 Accepting new patients
Eastpointe Human Services Past Accepting new patients
Clientfirst of NC, LLC Psychiatry PastSince Oct 15, 2012 Accepting new patients

Organizations & group practices 4

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": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274400000000",
    "number": "1154335511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1503 WAYNE MEMORIAL DR",
            "address_2": "SUITE H",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275342203",
            "telephone_number": "919-330-4367",
            "fax_number": "919-330-4375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1503 WAYNE MEMORIAL DR",
            "address_2": "SUITE H",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275342203",
            "telephone_number": "919-330-4367",
            "fax_number": "919-330-4375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "RALPH",
        "middle_name": "ROGER",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2010-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "33613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goldsboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2010; 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.