Active NPI
Kathleen Joyce Berg, MD
- Pediatrics Physician
- Kansas City, MO
National Provider Identifier
1225299282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 2015013428
- Practice address
- 2401 Gillham Rd
Kansas City, MO 64108-4619 - Phone
- (816) 234-3000
- NPI assigned
- Jun 23, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 2011-00407 | NC | |
| Pediatrics Physician | 208000000X | 22539 | MS | |
| Pediatrics Physician | 208000000X | 2015013428 | MO | Primary |
| Pediatrics Physician | 208000000X | 0437973 | KS |
Addresses
Primary practice location
2401 Gillham Rd
Kansas City, MO 64108-4619
Mailing address
2401 Gillham Rd
Kansas City, MO 64108-4619
Phone (816) 234-3000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 07556848 | Medicaid | MS |
Other names 1
- Dr. Kathleen Berg Wenning
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0437973 | KS | MD | Pediatrics Physician |
| 2015013428 | MO | MD | Pediatrics Physician |
| 22539 | MS | MD | Pediatrics Physician |
| 2011-00407 | NC | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214179200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438732800000",
"number": "1225299282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2401 GILLHAM RD",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641084619",
"telephone_number": "816-234-3000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2401 GILLHAM RD",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641084619",
"telephone_number": "816-234-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERG",
"first_name": "KATHLEEN",
"middle_name": "JOYCE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-23",
"last_updated": "2015-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NC",
"license": "2011-00407",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MS",
"license": "22539",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "2015013428",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "KS",
"license": "0437973",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "07556848",
"state": "MS"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KATHLEEN",
"last_name": "WENNING",
"middle_name": "BERG",
"prefix": "DR.",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Kansas City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.