Individual provider Active NPI

Jeryl L Berger, OTR/L

  • Occupational Therapist
  • Spring Hill, TN
National Provider Identifier
1366771503
Registry record updated May 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
6224 Issued in TN
Practice address
3011 Longford Dr
Spring Hill, TN 37174-6200
Phone
(615) 241-0122
Fax
(844) 308-4982
NPI assigned
Dec 17, 2009
Last updated
May 25, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 056-004979 IL
Occupational Therapist 225X00000X 6224 TN Primary

Addresses

Primary practice location

3011 Longford Dr
Spring Hill, TN 37174-6200

Mailing address

3011 Longford Dr
Spring Hill, TN 37174-6200
Phone (847) 566-9860

Other identifiers 1

IdentifierTypeStateIssuer
1366771503OtherTNNPI

Other names 1

  • Jeryl L Grecian Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200502000193 TN Practitioner - Occupational Therapist in Private Practice 8921439142 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Saint Louis University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arise Therapies LLCGroup PAC ID 5092086637, 13 clinicians

Practice addresses (Care Compare)

3011 Longford Dr
Suite 4
Spring Hill, TN 37174-6203
Phone (615) 241-0122

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056-004979ILMDSpecialist
6224TNMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Arise Therapies LLC CurrentSince Mar 28, 2020 Accepting new patients

Locations

3011 Longford Dr
Ste 4
Spring Hill, TN 37174
Phone (615) 241-0122

Organizations & group practices 1

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": "1261008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1366771503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3011 LONGFORD DR",
            "city": "SPRING HILL",
            "state": "TN",
            "postal_code": "371746200",
            "telephone_number": "847-566-9860",
            "fax_number": "847-566-9861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3011 LONGFORD DR",
            "city": "SPRING HILL",
            "state": "TN",
            "postal_code": "371746200",
            "telephone_number": "615-241-0122",
            "fax_number": "844-308-4982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGER",
        "first_name": "JERYL",
        "middle_name": "L",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-17",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "056-004979",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TN",
            "license": "6224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1366771503",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JERYL",
            "last_name": "GRECIAN",
            "middle_name": "L",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Spring Hill, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.