Angela D Berry, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1572 Issued in WV

Practice address

4605 Maccorkle Ave SW
South Charleston, WV 25309-1311

Phone

(304) 766-3589

Fax

(304) 766-3793

NPI assigned

May 25, 2007

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

• Mrs. Angela D Brumfield Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346451986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5409 TIFFANY DR",
            "city": "CROSS LANES",
            "state": "WV",
            "postal_code": "253131033",
            "telephone_number": "304-776-2706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4605 MACCORKLE AVE SW",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091311",
            "telephone_number": "304-766-3589",
            "fax_number": "304-766-3793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "ANGELA",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": "1572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI OPTIMUM CHOICE",
            "identifier": "2129415",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "BRUMFIELD",
            "middle_name": "D",
            "prefix": "MRS.",
            "credential": "P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Janet S. Bennett, FNP
• Robert J Benson II, PT, OCS
• Clinton Berczik
• Lyric Samone Berger
• Taylor Berkley
• D Duane Berry, DO
• Jonathan Berry
• Kathryn Ann Berry
• Leona May Berry
• Bez Psychiatric Services PLLC

• Physical Therapist in South Charleston, WV
• Providers in South Charleston, WV by specialty
• Physical Therapist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.