Berkeley Faye Gary

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN281144 Issued in GA

Practice address

1350 Walton Way
Augusta, GA 30901-2612

Phone

(706) 722-9011

NPI assigned

Oct 3, 2022

Last updated

Sep 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Berkeley Faye Bolin Former name

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

95.67 of 100Reported as group

Improvement activities

40

Cost

79.56

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Peach State Emergency Physicians LLC

  • Emergency Medicine Physician
  • Augusta, GA
  • NPI 1053170605
  Medicare reassignment NPD
• Acs Primary Care Physicians - Southeast PC

  • Emergency Medicine Physician
  • Myrtle Beach, SC
  • NPI 1861430555

  GA

  Medicare reassignment

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

{
    "created_epoch": "1664755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1275257388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 GREENE ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292084001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 WALTON WAY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309012612",
            "telephone_number": "706-722-9011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1601 Greene St",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292084001",
            "country_code": "US",
            "telephone_number": "803-777-7412",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2460 Washington Rd",
            "address_purpose": "LOCATION",
            "city": "Thomson",
            "state": "GA",
            "postal_code": "308246600",
            "country_code": "US",
            "telephone_number": "706-595-1411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARY",
        "first_name": "BERKELEY",
        "middle_name": "FAYE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-03",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN281144",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BERKELEY",
            "last_name": "BOLIN",
            "middle_name": "FAYE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Landon Garrison
• Jeffrey Robert Garver
• Barbara Jane Threatt Garvin, FNP
• Corey Garvin, M.D.
• Gary Williamson, M.D., P.C.
• William Ryan Gasque, PA-C
• Gastroenterology of Augusta, LLC
• Gastroenterology Specialists of Augusta, PC
• Christopher E Gates, MD.,FACS
• Sidney Austin Gates Jr., LMFT

• Nurse Practitioner in Augusta, GA
• Providers in Augusta, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.