Individual provider Active NPI

Kevin Raymonde Berning

  • Athletic Trainer
  • Englewood, CO
National Provider Identifier
1245749704
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT7045 Issued in TX
Practice address
175 Inverness Dr W
Englewood, CO 80112-5065
Phone
(303) 601-4099
NPI assigned
Sep 27, 2017
Last updated
Oct 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AT7045 TX Primary

Addresses

Primary practice location

175 Inverness Dr W
Englewood, CO 80112-5065

Mailing address

1989 Blue Sage LN
Castle Rock, CO 80104-7888
Phone (303) 601-4099

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

State licenses

LicenseStateTypeSpecialty
AT7045TXMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1506470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1245749704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1989 BLUE SAGE LN",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801047888",
            "telephone_number": "303-601-4099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 INVERNESS DR W",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801125065",
            "telephone_number": "303-601-4099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNING",
        "first_name": "KEVIN",
        "middle_name": "RAYMONDE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-27",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT7045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2024; 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.