Individual provider Active NPI

Madison Victoria Berridge

  • Behavior Technician
  • Ada, MI
National Provider Identifier
1235612672
Registry record updated Oct 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
7922 E Dogwood Meadows CT SE
Ada, MI 49301-9440
Phone
(517) 898-7328
NPI assigned
Sep 12, 2018
Last updated
Oct 9, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X NU Primary

Addresses

Primary practice location

7922 E Dogwood Meadows CT SE
Ada, MI 49301-9440

Mailing address

7922 E Dogwood Meadows CT SE
Ada, MI 49301-9440
Phone (517) 898-7328

Other practice location 1

27777 Inkster Rd Ste 100
Farmington Hills, MI 48334-5326
Phone (248) 436-4476

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

Practice roles

OrganizationSpecialtyStatusNew patients
Centered Care LLC Current Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1536710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570579200000",
    "number": "1235612672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7922 E DOGWOOD MEADOWS CT SE",
            "city": "ADA",
            "state": "MI",
            "postal_code": "493019440",
            "telephone_number": "517-898-7328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7922 E DOGWOOD MEADOWS CT SE",
            "city": "ADA",
            "state": "MI",
            "postal_code": "493019440",
            "telephone_number": "517-898-7328"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27777 Inkster Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Farmington Hills",
            "state": "MI",
            "postal_code": "483345326",
            "country_code": "US",
            "telephone_number": "248-436-4476",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERRIDGE",
        "first_name": "MADISON",
        "middle_name": "VICTORIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-12",
        "last_updated": "2019-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ada, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2019; 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.