NPIMap

Individual provider Active NPI

Ryan Darrell Berry, MD, PHD

  • Internal Medicine Physician
  • Gainesville, GA
National Provider Identifier
1154881118
Registry record updated Aug 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
91158 Issued in GA
Practice address
725 Jesse Jewell Pkwy SE
Gainesville, GA 30501-3834
Phone
(705) 535-0191
Fax
(770) 533-4786
NPI assigned
Mar 24, 2019
Last updated
Aug 8, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 91158 GA Primary

Addresses

Primary practice location

725 Jesse Jewell Pkwy SE
Gainesville, GA 30501-3834

Mailing address

PO Box 658
Gainesville, GA 30503-0658
Phone (707) 181-1227

Other practice location 1

734 Spring St SE Ste 710
Gainesville, GA 30501
Phone (770) 219-8730

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220808001168 GA Practitioner - Internal Medicine 6608117924 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Alabama School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Longstreet Clinic, PCGroup PAC ID 2668465733, 140 clinicians
Northeast Georgia Community Physicians LLCGroup PAC ID 3274010582, 129 clinicians

Practice addresses (Care Compare)

1321 Interstate Pkwy
Augusta, GA 30909-5626
Phone (706) 945-0810

725 Jesse Jewell Pkwy SE
Gainesville, GA 30501-3834
Phone (770) 533-6511

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.1 of 100Reported as group
Quality
87.6
Promoting interoperability
100
Improvement activities
40
Cost
76.07

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Longstreet Clinic PC CurrentSince Aug 1, 2022 Accepting new patients
The Longstreet Clinic, PC Internal Medicine CurrentSince Aug 1, 2022 Accepting new patients
Northeast Georgia Community Physicians LLC Internal Medicine CurrentSince Feb 1, 2026 Accepting new patients

Locations

725 Jesse Jewell Pkwy SE
Gainesville, GA 30501
Phone (770) 297-2200

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1553385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659916800000",
    "number": "1154881118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 658",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305030658",
            "telephone_number": "707-181-1227",
            "fax_number": "770-533-4786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 JESSE JEWELL PKWY SE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013834",
            "telephone_number": "705-535-0191",
            "fax_number": "770-533-4786"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "734 Spring St SE Ste 710",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "GA",
            "postal_code": "30501",
            "country_code": "US",
            "telephone_number": "770-219-8730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERRY",
        "first_name": "RYAN",
        "middle_name": "DARRELL",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-24",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "91158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.