NPIMap

Organization Active NPI

Robert G Berry Jr Elko Chartered LLC

Doing business as Elko Spine and Rehabilitation

  • Physical Medicine & Rehabilitation Physician
  • Elko, NV
National Provider Identifier
1386986206
Registry record updated Oct 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
ROBERT G BERRY JR ELKO CHARTERED LLC
Doing business as
Elko Spine and Rehabilitation
Practice address
2219 N 5TH St
Elko, NV 89801-2483
Phone
(775) 777-9669
Fax
(775) 778-9559
NPI assigned
Mar 18, 2013
Last updated
Oct 1, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2020

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

Authorized official

Name
Becky J Thompson
Title
Office Manager
Phone
(775) 777-9669

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

2219 N 5TH St
Elko, NV 89801-2483

Mailing address

2219 N 5TH St
Elko, NV 89801-2483
Phone (775) 777-9669

Other names 1

  • Elko Spine and Rehabilitation Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Elko

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141229000181 NV Part B Supplier - Clinic/Group Practice 0446573380 Receives reassigned benefits from 13 practitioners
Practice locations: Elko, NV

National Provider Directory

National Provider Directory

Locations

2219 N 5th St
Ste A
Elko, NV 89801
Phone (775) 777-1224

6630 S McCarran Blvd
Ste A4
Reno, NV 89509
Phone (775) 282-2873

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1363564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601510400000",
    "number": "1386986206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2219 N 5TH ST",
            "city": "ELKO",
            "state": "NV",
            "postal_code": "898012483",
            "telephone_number": "775-777-9669",
            "fax_number": "775-778-9559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2219 N 5TH ST",
            "city": "ELKO",
            "state": "NV",
            "postal_code": "898012483",
            "telephone_number": "775-777-9669",
            "fax_number": "775-778-9559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT G BERRY JR ELKO CHARTERED LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-18",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "BECKY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "775-777-9669"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Elko",
            "affiliation": "N",
            "address_1": "2219 N 5th St",
            "city": "Elko",
            "state": "NV",
            "country_code": "US",
            "postal_code": "898012483",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Elko Spine and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elko, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.