Keely Erin Berry, CRNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

1089150 Issued in AL

Practice address

1600 7TH Ave S
Birmingham, AL 35233-1711

Phone

(205) 939-9175

Fax

(205) 558-2061

NPI assigned

Jan 30, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Keely Erin Eagan Former name

Medicare fee-for-service enrollment

Enrolled in AL

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

Specialty

Nurse Practitioner

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Alabama Health Services Foundation, PCGroup PAC ID 1951213107, 2,784 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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 and National Provider Directory roles.

• University of Alabama Health Services Foundation, PC.

  • Multi-Specialty Clinic/Center
  • Birmingham, AL
  • NPI 1093768723
  Medicare reassignment Care Compare group NPD
• University of Alabama Health Services Foundation, PC

  • Pediatrics Physician
  • Birmingham, AL
  • NPI 1356377576
  NPD
• The Children'S Hospital of Alabama

  • Pediatrics Physician
  • Hueytown, AL
  • NPI 1104903749
  NPD (past)

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

{
    "created_epoch": "1201651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201651200000",
    "number": "1306023528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 OAK PARK LN",
            "city": "HELENA",
            "state": "AL",
            "postal_code": "350807753",
            "telephone_number": "205-939-9175",
            "fax_number": "205-558-2061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 7TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331711",
            "telephone_number": "205-939-9175",
            "fax_number": "205-558-2061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "KEELY",
        "middle_name": "ERIN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-30",
        "last_updated": "2008-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AL",
            "license": "1089150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1089150",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEELY",
            "last_name": "EAGAN",
            "middle_name": "ERIN",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Moussa Mohamed Berro, MD
• Abigail Berry, MD
• Anslee Elise Berry
• David Andrew Berry, DO
• Jonathan Thompson Berry, OT
• Lakeisha Berry, CCMA
• Nicholas Scott Berry, CRNA
• Payton Madison Berry, PA
• Sarah M. Berry, OD
• Ellery Cook Berryhill, ALC., ALMFT

• Pediatric Nurse Practitioner in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Pediatric Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2008; 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.