Laurie D Berdahl, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

35412 Issued in CO

Practice address

2410 W 16TH St
Greeley, CO 80634-6004

Phone

(970) 352-6353

Fax

(970) 356-2264

NPI assigned

Sep 13, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Banner Greeley Specialists

  • Multi-Specialty Clinic/Center
  • Greeley, CO
  • NPI 1558595611
  NPD (past)

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322611200000",
    "number": "1194710392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 W 16TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806346004",
            "telephone_number": "970-352-6353",
            "fax_number": "970-356-2264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 W 16TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806346004",
            "telephone_number": "970-352-6353",
            "fax_number": "970-356-2264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERDAHL",
        "first_name": "LAURIE",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-13",
        "last_updated": "2011-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CO",
            "license": "35412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "10381125",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ROCKY MTN HEALTH",
            "identifier": "840592369006",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "BE41887",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PACIFICARE",
            "identifier": "84059236906",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01354125",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sophia Linnea Bennett
• Connye Victoria Benson
• Alyssa Leigh Benton
• Shelby Dawn Benton, RN
• Stephanie Anne Berbrich, PA
• Nancy A Berg-Audette, N.P.
• Madeline Berg
• John Paul Berger, D.O.
• Alexandra Bergsten, MS CCC-SLP
• Allison Bernal, MS, LPCC

• Specialist in Greeley, CO
• Providers in Greeley, CO by specialty
• Specialist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2011; 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.