Individual provider Active NPI

Carly Berg, MD

  • Pediatrics Physician
  • Arlington, WA
National Provider Identifier
1336554658
Registry record updated Jan 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD70007528 Issued in WA
Practice address
875 Wesley St
Arlington, WA 98223-1613
Phone
(360) 435-6525
Fax
(360) 435-2634
NPI assigned
Jun 25, 2014
Last updated
Jan 16, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD70007528 WA Primary
Pediatrics Physician 208000000X 2014020062 MO

Addresses

Primary practice location

875 Wesley St
Arlington, WA 98223-1613

Mailing address

1400 E Kincaid St
Mount Vernon, WA 98274-4127

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cberg79139@skagit.direct-ci.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170829003425 IL Practitioner - Pediatric Medicine 5597038471 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2014020062MOMDPediatrics Physician
MD70007528WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Erie Family Health Center Inc. CurrentSince Aug 21, 2017 Accepting new patients
Erie Family Health Center Inc CurrentSince Aug 21, 2017 Accepting new patients
Erie Family Health Center, Inc Current Accepting new patients
Public Hospital Dist No 1 Skagit Past Accepting new patients

Locations

1504 S Albany Ave
Chicago, IL 60623

1701 W Superior St
Chicago, IL 60622
Phone (312) 432-7392

1701 W Superior St
Fl 3
Chicago, IL 60622
Phone (312) 432-2678

2750 W North Ave
Chicago, IL 60647
Phone (312) 432-2767

Interoperability endpoints

  • Direct secure messaging: cberg368110@direct.ochin.org
  • Direct secure messaging: cberg79139@skagit.direct-ci.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1403654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768521600000",
    "number": "1336554658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E KINCAID ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 WESLEY ST",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "982231613",
            "telephone_number": "360-435-6525",
            "fax_number": "360-435-2634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "CARLY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-25",
        "last_updated": "2026-01-16",
        "certification_date": "2026-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD70007528",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2014020062",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cberg79139@skagit.direct-ci.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "875 Wesley St",
            "city": "Arlington",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982231613",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Arlington, WA

Sources for this page

Verify at the official NPI Registry.