Active NPI
Kristin Emily Berry, D.O.
- Obstetrics & Gynecology Physician
- Redmond, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- DO156086
- Practice address
- 340 NW 5TH St
Redmond, OR 97756-1869 - Phone
- (541) 526-6635
- Fax
- (541) 526-6636
- NPI assigned
- Jul 26, 2007
- Last updated
- Apr 20, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 5101017373 | MI | |
| Obstetrics & Gynecology Physician | 207V00000X | 5315031830 | MI | |
| Obstetrics & Gynecology Physician | 207V00000X | DO156086 | OR | Primary |
Addresses
Primary practice location
340 NW 5TH St
Redmond, OR 97756-1869
Mailing address
3640 NW Samaritan Dr
Ste 270
Corvallis, OR 97330-3784
Phone (541) 768-5300
Other names 1
- Dr. Kristin E Wagner
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kberry85063@secure.stcharleshealthcare.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Obstetrics/Gynecology
- Education
- Michigan State University College of Osteopathic Medicine, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1253 NW Canal Blvd
Adv Illness Manag
Redmond, OR 97756-1334
Phone (541) 706-5880
211 NW Larch Ave
Family Care
Redmond, OR 97756-1357
Phone (541) 548-2164
2500 NE Neff Rd
Bend, OR 97701-6015
340 NW 5TH St
101 Cent Women HT
Redmond, OR 97756-1869
Phone (541) 526-6635
655 NW Jackpine Ave
Sleep Cent
Redmond, OR 97756-1334
Phone (541) 526-6661
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of the uterus | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101017373 | MI | MD | Obstetrics & Gynecology Physician |
| 5315031830 | MI | MD | Obstetrics & Gynecology Physician |
| DO156086 | OR | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Charles Health System, Inc. | Current | Accepting new patients | |
| St. Charles Health System, Inc. | Current | Accepting new patients | |
| Obhg Oregon PC | Obstetrics & Gynecology | Current | Accepting new patients |
| St. Charles Health System, Inc. | Current | Accepting new patients | |
| St. Charles Health System, Inc. | Current | Accepting new patients | |
| Good Samaritan Hospital Corvallis | Past | Accepting new patients | |
| Firstcare Medical Foundation | Obstetrics & Gynecology | Past | Accepting new patients |
Locations
29358 Network Pl
Chicago, IL 60673
1885 NE Purcell Blvd
Bend, OR 97701
Phone (541) 706-2700
2500 NE Neff Rd
Bend, OR 97701
Phone (541) 388-4333
61250 SE Coombs Pl
Bend, OR 97702
Phone (541) 706-5930
51781 Huntington Rd
La Pine, OR 97739
Phone (541) 666-7920
470 NE A St
Madras, OR 97741
Phone (541) 383-3668
2825 E Barnett Rd
Medford, OR 97504
Phone (541) 282-6770
384 SE Combs Flat Rd
Ste 1200
Prineville, OR 97754
Phone (541) 447-6263
1253 NW Canal Blvd
Redmond, OR 97756
Phone (541) 548-8131
211 NW Larch Ave
Redmond, OR 97756
Phone (541) 548-2164
340 NW 5th St
Redmond, OR 97756
Phone (541) 504-2218
340 NW 5th St
Ste 101
Redmond, OR 97756
Phone (734) 545-3348
630 N Arrowleaf Trl
Sisters, OR 97759
Phone (541) 549-1318
Interoperability endpoints
- kberry85063@secure.stcharleshealthcare.org
Organizations & group practices 7
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.
-
dba St. Charles Medical Group
- Family Medicine Physician
- Bend, OR
- NPI 1023331303
-
dba St. Charles Bend
- General Acute Care Hospital
- Bend, OR
- NPI 1982621447
-
dba St. Charles Medical Center - Bend
- Rehabilitation Hospital Unit
- Bend, OR
- NPI 1154343150
-
dba The Center at St. Charles Medical Equipment
- Specialist
- Bend, OR
- NPI 1700697935
-
dba Samaritan Medical Clinics
- Family Medicine Physician
- Albany, OR
- NPI 1740216498
Obstetrics & Gynecology
-
dba Samaritan Orthopedics-Luis Vela, DO
- Durable Medical Equipment & Medical Supplies
- Corvallis, OR
- NPI 1477851186
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba NW High Desert Sleep Center Bend
- Sleep Disorder Diagnostic Clinic/Center
- Bend, OR
- NPI 1164675963
Hospital
-
dba St. Charles Prineville
- Critical Access Hospital
- Prineville, OR
- NPI 1710160445
-
dba St. Charles Bend
- General Acute Care Hospital
- Bend, OR
- NPI 1982621447
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1587340800000",
"number": "1306036314",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3640 NW SAMARITAN DR",
"address_2": "STE 270",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973303784",
"telephone_number": "541-768-5300",
"fax_number": "541-768-5251"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "340 NW 5TH ST",
"city": "REDMOND",
"state": "OR",
"postal_code": "977561869",
"telephone_number": "541-526-6635",
"fax_number": "541-526-6636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERRY",
"first_name": "KRISTIN",
"middle_name": "EMILY",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-26",
"last_updated": "2020-04-20",
"certification_date": "2020-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "MI",
"license": "5101017373",
"primary": false
},
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "MI",
"license": "5315031830",
"primary": false
},
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "OR",
"license": "DO156086",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kberry85063@secure.stcharleshealthcare.org",
"affiliation": "N",
"address_1": "340 NW 5th St",
"city": "Redmond",
"state": "OR",
"country_code": "US",
"postal_code": "977561869",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "KRISTIN",
"last_name": "WAGNER",
"middle_name": "E",
"prefix": "DR.",
"credential": "DO",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Redmond, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2020; 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.