Active NPI
Ronald Arthur Berry, RN, FNP
- Family Nurse Practitioner
- Warm Springs, OR
National Provider Identifier
1285625822
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 17377.148
- Practice address
- 1270 Kotnum Road
Warm Springs, OR 97761-1209 - Phone
- (541) 553-1196
- Fax
- (541) 553-2457
- NPI assigned
- Nov 2, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 17377.148 | WY | Primary |
Addresses
Primary practice location
1270 Kotnum Road
Warm Springs, OR 97761-1209
Mailing address
PO Box 1209
Warm Springs, OR 97761-1209
Phone (541) 553-1196
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 273855 | Medicaid | OR | |
| HSZ204 | Other | OR | MEDICARE FEDERAL HEALTH CARE FACILITY |
| 8HD971 | Other | NM | PERSONAL MEDICARE ID |
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
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17377.148 | WY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jicarilla IHS Pharmacy | Past | Accepting new patients | |
| US Health Dept of Health & Human Services | Past | Accepting new patients | |
| US Health Dept of Health & Human Services | Past | Accepting new patients |
Organizations & group practices 3
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.
-
dba Dulce IHS Pharmacy
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
- Dulce, NM
- NPI 1124220900
-
- Federal Public Health Clinic/Center
- Fort Washakie, WY
- NPI 1023174299
-
- Federal Public Health Clinic/Center
- Arapahoe, WY
- NPI 1104976372
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1269993600000",
"number": "1285625822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1209",
"city": "WARM SPRINGS",
"state": "OR",
"postal_code": "977611209",
"telephone_number": "541-553-1196",
"fax_number": "541-553-2457"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1270 KOTNUM ROAD",
"city": "WARM SPRINGS",
"state": "OR",
"postal_code": "977611209",
"telephone_number": "541-553-1196",
"fax_number": "541-553-2457"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERRY",
"first_name": "RONALD",
"middle_name": "ARTHUR",
"name_prefix": "Mr.",
"credential": "RN, FNP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-02",
"last_updated": "2010-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WY",
"license": "17377.148",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "273855",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE FEDERAL HEALTH CARE FACILITY",
"identifier": "HSZ204",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PERSONAL MEDICARE ID",
"identifier": "8HD971",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Warm Springs, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.