Active NPI
Cheryl Len Berry, PT
- Physical Therapist
- Cape Coral, FL
National Provider Identifier
1326683335
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT11205
- Practice address
- 58 Nicholas Pkwy W # 105
Cape Coral, FL 33991-2845 - Phone
- (239) 424-9904
- Fax
- (239) 317-0268
- NPI assigned
- Nov 13, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT11205 | FL | Primary |
Addresses
Primary practice location
58 Nicholas Pkwy W # 105
Cape Coral, FL 33991-2845
Mailing address
58 Nicholas Pkwy W # 105
Cape Coral, FL 33991-2845
Phone (239) 424-9904
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT11205 | Other | FL | MEDICAL LICENSE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Direct |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT11205 | FL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Johner Therapy Inc | Single Specialty | Past | Accepting new patients |
| Johner Therapy Inc | Single Specialty | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1573603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1573603200000",
"number": "1326683335",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "58 NICHOLAS PKWY W # 105",
"city": "CAPE CORAL",
"state": "FL",
"postal_code": "339912845",
"telephone_number": "239-424-9904",
"fax_number": "239-317-0268"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "58 NICHOLAS PKWY W # 105",
"city": "CAPE CORAL",
"state": "FL",
"postal_code": "339912845",
"telephone_number": "239-424-9904",
"fax_number": "239-317-0268"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERRY",
"first_name": "CHERYL",
"middle_name": "LEN",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-11-13",
"last_updated": "2019-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT11205",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "PT11205",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "email",
"affiliation": "N",
"endpointDescription": "email",
"use": "DIRECT",
"useDescription": "Direct",
"useOtherDescription": "email",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"contentOtherDescription": "cape coral",
"address_1": "58 Nicholas Pkwy W # 105",
"city": "Cape Coral",
"state": "FL",
"country_code": "US",
"postal_code": "339912845",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Cape Coral, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.