Active NPI
Kelly Berryman
- Doula
- Bloomington, IL
National Provider Identifier
1194568386
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Doula
- Practice address
- 803 S Allin St
Bloomington, IL 61701-6407 - Phone
- (309) 444-0692
- NPI assigned
- Jun 14, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Doula | 374J00000X | Primary |
Addresses
Primary practice location
803 S Allin St
Bloomington, IL 61701-6407
Mailing address
803 S Allin St
Bloomington, IL 61701-6407
Phone (309) 444-0692
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718323200000",
"number": "1194568386",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "803 S ALLIN ST",
"city": "BLOOMINGTON",
"state": "IL",
"postal_code": "617016407",
"telephone_number": "309-444-0692"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "803 S ALLIN ST",
"city": "BLOOMINGTON",
"state": "IL",
"postal_code": "617016407",
"telephone_number": "309-444-0692"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERRYMAN",
"first_name": "KELLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-06-14",
"last_updated": "2024-06-14",
"certification_date": "2024-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "374J00000X",
"taxonomy_group": "",
"desc": "Doula",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.