Kevin Berryman, LP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1086 Issued in NE

Practice address

11905 Arbor St
Omaha, NE 68144-2970

Phone

(402) 522-6502

Fax

(531) 325-9339

NPI assigned

Feb 21, 2007

Last updated

Jul 27, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2026 through Jan 1, 2028

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Kevin Berryman, LLC

  • Clinical Psychologist
  • Omaha, NE
  • NPI 1114732971
  NPD Authorized official

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1194860593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5821 CHARLES ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681321320",
            "telephone_number": "402-522-6502",
            "fax_number": "531-325-9339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11905 ARBOR ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681442970",
            "telephone_number": "402-522-6502",
            "fax_number": "531-325-9339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRYMAN",
        "first_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "LP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NE",
            "license": "1086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47037660626",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20025660400",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47037660631",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Teresa Berry
• Thomas P Berry, DDS
• Yasmina Unique Berry
• Abby Berryman
• James Berryman
• Jill Bersane
• Danielle E Bertch
• Mark Bertch, PT, DPT, OCS, CSCS
• Carrie A. Bertellotti, APRN ACNP-BC
• Jacqueline Lynn Bertelsen, RD, LD, LMNT

• Clinical Psychologist in Omaha, NE
• Providers in Omaha, NE by specialty
• Clinical Psychologist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.