Individual provider Active NPI

Daniel Berg, ARDMS/ARRT

  • Radiologic Technologist
  • Watertown, SD
National Provider Identifier
1154581536
Registry record updated Jun 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiologic TechnologistTaxonomy code 247100000X
License
ARDMS5701 Issued in SD
Practice address
420 4TH St NE Ste 122
Watertown, SD 57201-2658
Phone
(605) 886-5709
Fax
(605) 886-5723
NPI assigned
Jun 10, 2008
Last updated
Jun 10, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiologic Technologist 247100000X ARDMS5701 SD Primary

Addresses

Primary practice location

420 4TH St NE Ste 122
Watertown, SD 57201-2658

Mailing address

420 4TH St NE Ste 122
Watertown, SD 57201-2658
Phone (605) 886-5709

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
ARDMS5701SDMDRadiologic Technologist

NPI Registry JSON

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

{
    "created_epoch": "1213056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213056000000",
    "number": "1154581536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 4TH ST NE STE 122",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572012658",
            "telephone_number": "605-886-5709",
            "fax_number": "605-886-5723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 4TH ST NE STE 122",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572012658",
            "telephone_number": "605-886-5709",
            "fax_number": "605-886-5723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "DANIEL",
        "credential": "ARDMS/ARRT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-10",
        "last_updated": "2008-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247100000X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist",
            "state": "SD",
            "license": "ARDMS5701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2008; 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.