Jennifer Kaye Berg

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OTR1600 Issued in AR

Practice address

2615 W Main St
Jacksonville, AR 72076-4215

Phone

(501) 982-4578

Fax

(507) 982-1253

NPI assigned

Nov 21, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Jennifer Kaye Gaddis Former name

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.

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.

• Pathfinder, Inc.

  • Developmentally Disabled Services Day Training Agency
  • Jacksonville, AR
  • NPI 1326004466
  NPD (past)
• Pathfinder, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Jacksonville, AR
  • NPI 1629035043
  NPD (past)

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197936000000",
    "number": "1245305788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 CYPRESS ST",
            "city": "CENTERTON",
            "state": "AR",
            "postal_code": "727198991",
            "telephone_number": "479-633-2416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 W MAIN ST",
            "city": "JACKSONVILLE",
            "state": "AR",
            "postal_code": "720764215",
            "telephone_number": "501-982-4578",
            "fax_number": "507-982-1253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "JENNIFER",
        "middle_name": "KAYE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2007-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AR",
            "license": "OTR1600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "GADDIS",
            "middle_name": "KAYE",
            "prefix": "MISS",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amy Louise Belew, MHPP
• Harli E Belk, LAC
• Kathryn Elizabeth Bell, MS RD LD
• Amanda Gail Bellamy, PHARM D
• Blake W Bennett, D.C.
• Katelyn Marie Berg, LMSW
• Joanna L. Berry, LMFT
• Ken Berry, LMFT
• Marsha Moore Bertasi, OTR/L
• Big Chief Transport Service, LLC

• Occupational Therapist in Jacksonville, AR
• Providers in Jacksonville, AR by specialty
• Occupational Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2007; 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.