Individual provider Active NPI

Stacey Hale Berner, MD

  • Orthopaedic Surgery Physician
  • Owings Mills, MD
National Provider Identifier
1154339620
Registry record updated Aug 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
D0046117 Issued in MD
Practice address
10 Crossroads Dr
Suite 210
Owings Mills, MD 21117-5458
Phone
(410) 484-8088
Fax
(410) 581-9485
NPI assigned
Aug 3, 2006
Last updated
Aug 3, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X D0046117 MD Primary
Orthopaedic Surgery Physician 207X00000X 0101045738 VA
Orthopaedic Hand Surgery Physician 207XS0106X C10005022 DE

Addresses

Primary practice location

10 Crossroads Dr
Suite 210
Owings Mills, MD 21117-5458

Mailing address

10 Crossroads Dr
Suite 210
Owings Mills, MD 21117-5458
Phone (410) 484-8088

Other identifiers 3

IdentifierTypeStateIssuer
160631000MedicaidMD
53253404OtherMDBLUE SHIELD
W5200002OtherDCBLUE SHIELD

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

State licenses

LicenseStateTypeSpecialty
0101045738VAMDOrthopaedic Surgery Physician
C10005022DEMDOrthopaedic Hand Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280793600000",
    "number": "1154339620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CROSSROADS DR",
            "address_2": "SUITE 210",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175458",
            "telephone_number": "410-484-8088",
            "fax_number": "410-581-9485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 CROSSROADS DR",
            "address_2": "SUITE 210",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175458",
            "telephone_number": "410-484-8088",
            "fax_number": "410-581-9485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNER",
        "first_name": "STACEY",
        "middle_name": "HALE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2010-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MD",
            "license": "D0046117",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "VA",
            "license": "0101045738",
            "primary": false
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "DE",
            "license": "C10005022",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "160631000",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "53253404",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "W5200002",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Owings Mills, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 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.