Active NPI
David P Berg, D.O.
- Emergency Medicine Physician
- Springfield, IL
National Provider Identifier
1366486268
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- Practice address
- 701 N 1St St
Springfield, IL 62781-0001 - Phone
- (217) 788-3156
- NPI assigned
- Jun 15, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | IL | Primary |
Addresses
Primary practice location
701 N 1St St
Springfield, IL 62781-0001
Mailing address
PO Box 955277
Saint Louis, MO 63195-5277
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0360856471 | Medicaid | IL |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051006000272 | IL | Practitioner - Emergency Medicine | 8527960053 | Reassigns benefits to 2 organizations |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Midwest Emergency Department Specialists LTD | Emergency Medicine | Current | Accepting new patients |
| Taylorville Memorial Hospital | Current | Accepting new patients | |
| Taylorville Memorial Hospital | Current | Accepting new patients | |
| Taylorville Memorial Hospital | Current | Accepting new patients |
Locations
2300 N Edward St
Decatur, IL 62526
Phone (217) 876-3000
701 N 1st St
Springfield, IL 62781
Phone (217) 788-3100
201 E Pleasant St
Taylorville, IL 62568
Phone (217) 707-5555
Interoperability endpoints
- https://fhir-usa.unify.chbase.com/org/stvince-659560ec
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 and National Provider Directory roles.
-
- Emergency Medicine Physician
- Springfield, IL
- NPI 1245263367
Emergency Medicine, IL
-
- Medicare Defined Swing Bed Hospital Unit
- Taylorville, IL
- NPI 1275506636
-
- Certified Registered Nurse Anesthetist
- Taylorville, IL
- NPI 1518170729
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184198400000",
"number": "1366486268",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 955277",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631955277"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 N 1ST ST",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627810001",
"telephone_number": "217-788-3156"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERG",
"first_name": "DAVID",
"middle_name": "P",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-15",
"last_updated": "2007-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0360856471",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Springfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.