Kathleen M Berry, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP-3489 Issued in AZ

Practice address

5859 W Talavi Blvd
Suite 100
Glendale, AZ 85306-1869

Phone

(602) 298-7777

Fax

(623) 930-6060

NPI assigned

Nov 24, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Kathleen M Berry Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1259020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273708800000",
    "number": "1174851547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5859 W TALAVI BLVD",
            "address_2": "SUITE 100",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853061869",
            "telephone_number": "602-298-7777",
            "fax_number": "623-930-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5859 W TALAVI BLVD",
            "address_2": "SUITE 100",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853061869",
            "telephone_number": "602-298-7777",
            "fax_number": "623-930-6060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "KATHLEEN",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-24",
        "last_updated": "2010-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP-3489",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN137226",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "BERRY",
            "middle_name": "M",
            "prefix": "MS.",
            "credential": "FNP-BC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Karen Lea Berrigan, DMD
• Jessica Aurora Berrio
• Andres Isaiah Berrios
• Amanda J Berry, PT
• Julia Gail Berry, OTR/L
• Kayla Berry
• Karen Cheri Berryhill, LMSW
• Eddrena Bertram, PHLEBOTOMIST TECH
• Jeanne F Bertuna, BSN
• Melissa Berutto

• Family Nurse Practitioner in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.