Robert G Berry Jr MD

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

Legal business name

ROBERT G BERRY JR MD

Doing business as

Mountain West Sport and Spine
Orthopedic Rehabilitation Specialists of Nevada

Practice address

6630 S McCarran Blvd
A-4 Sierra Regional Spine Institute
Reno, NV 89509-6136

Phone

(775) 828-2873

Fax

(775) 828-2889

NPI assigned

Dec 20, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Ashley B Georgetta

Title

Practice Administrator

Phone

(775) 448-9456

Specialties & licenses 1

Addresses

Other names 2

• Mountain West Sport and Spine Doing business as
• Orthopedic Rehabilitation Specialists of Nevada Doing business as

Tax ID family

Mountain West Sport and Spine2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Robert G. Berry LTD - Ortho Rehab Specialists of Nevada

  • Non-Pharmacy Dispensing Site
  • Reno, NV
  • NPI 1710429634
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert G Berry Jr., MD

  • Physical Medicine & Rehabilitation Physician
  • Reno, NV
  • NPI 1356327522
  NPD (past)
• Star Ray Chenoweth, PA-C

  • Surgical Physician Assistant
  • Carson City, NV
  • NPI 1386970614
  NPD (past)

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

{
    "created_epoch": "1135036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665360000000",
    "number": "1306822499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6630 S MCCARRAN BLVD STE A3",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895096184",
            "telephone_number": "775-828-2863",
            "fax_number": "665-710-0568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6630 S MCCARRAN BLVD",
            "address_2": "A-4 SIERRA REGIONAL SPINE INSTITUTE",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895096136",
            "telephone_number": "775-828-2873",
            "fax_number": "775-828-2889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT G BERRY JR MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-20",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-10",
        "status": "A",
        "authorized_official_last_name": "GEORGETTA",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "775-448-9456",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mountain West Sport and Spine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Orthopedic Rehabilitation Specialists of Nevada",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Orthopedic Rehabilitation Specialists of Nevada",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Natasha Roadruck
• Susan Robards
• Kimberley Roberson
• Nora Roberson
• Robert G Berry Jr LTD (Mountain West Sport and Spine)
• Robert G. Berry LTD - Ortho Rehab Specialists of Nevada
• Robert J Riley LTD (Aistheta)
• Robert J. Rosenquist, CHTD.
• Robert S Fredericks MD LTD (Endocrine Associates)
• Robert S. Fredericks MD LTD.

• Interventional Pain Medicine Physician in Reno, NV
• Providers in Reno, NV by specialty
• Interventional Pain Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2022; 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.