NPIMap

Individual provider Active NPI

Jonathan Thomas Berry, MD

  • Family Medicine Physician
  • Little Rock, AR
National Provider Identifier
1346731932
Registry record updated Jul 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E-13520 Issued in AR
Practice address
11415 Executive Center Dr
Little Rock, AR 72211-4489
Phone
(501) 224-5220
Fax
(501) 228-9828
NPI assigned
May 20, 2018
Last updated
Jul 1, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X E-13520 AR Primary

Addresses

Primary practice location

11415 Executive Center Dr
Little Rock, AR 72211-4489

Mailing address

11415 Executive Center Dr
Little Rock, AR 72211-4489
Phone (501) 224-5220

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201027001509 AR Practitioner - Family PracticePractitioner - Emergency Medicine 1658629928 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
University of Arkansas College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Arkansas Family Care NetworkGroup PAC ID 0648256800, 30 clinicians

Practice addresses (Care Compare)

11415 Executive Ctr Dr
Barg Family Clinic
Little Rock, AR 72211-4489
Phone (501) 224-5220

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-13520ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Monticello Ess LLC CurrentSince Sep 30, 2020 Accepting new patients
Arkansas Emergency Staffing Solutions, Inc CurrentSince Oct 1, 2020 Accepting new patients
Arkansas Family Care Network Family Medicine CurrentSince Jul 1, 2021 Accepting new patients
Emergency Staffing Solutions Region III CurrentSince Sep 25, 2020 Accepting new patients

Locations

1015 Unity Rd
Crossett, AR 71635
Phone (870) 364-0590

11415 Executive Center Dr
Little Rock, AR 72211
Phone (501) 224-5220

4208 N Rodney Parham Rd
Little Rock, AR 72212
Phone (501) 223-0779

101 Hospital Dr
Magnolia, AR 71753
Phone (870) 235-3000

778 Scogin Dr
Monticello, AR 71655
Phone (870) 367-2411

5125 Northshore Dr
North Little Rock, AR 72118

Interoperability endpoints

  • Direct secure messaging: jberry277166@direct.baptist-healthar.org
  • Direct secure messaging: jonathan.berry@afcn.eclinicaldirectplus.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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1526774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1346731932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11415 EXECUTIVE CENTER DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114489",
            "telephone_number": "501-224-5220",
            "fax_number": "501-228-9828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11415 EXECUTIVE CENTER DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114489",
            "telephone_number": "501-224-5220",
            "fax_number": "501-228-9828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "JONATHAN",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-20",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-13520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.