Individual provider Active NPI

Shanna Naomi Berry-Vo, DO

  • Infectious Disease Physician
  • Anchorage, AK
National Provider Identifier
1407290430
Registry record updated Aug 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
173495 Issued in AK
Practice address
4120 Laurel St Ste 204
Anchorage, AK 99508-5392
Phone
(907) 561-4362
Fax
(907) 563-4362
NPI assigned
Apr 21, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 173495 AK Primary

Addresses

Primary practice location

4120 Laurel St Ste 204
Anchorage, AK 99508-5392

Mailing address

4120 Laurel St Ste 204
Anchorage, AK 99508-5392
Phone (907) 561-4362

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220111000580 AK Practitioner - Infectious DiseasePractitioner - Internal Medicine 8325353584 Practice locations: Anchorage, AK

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Rowan University School of Osteopathic Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3500 Latouche St
Suite 200
Anchorage, AK 99508-4248
Phone (907) 561-4362

Hospital & facility affiliations

National Provider Directory

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

Hospital & facility affiliations 2

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": "1366502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630022400000",
    "number": "1407290430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4120 LAUREL ST STE 204",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085392",
            "telephone_number": "907-561-4362",
            "fax_number": "907-563-4362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4120 LAUREL ST STE 204",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085392",
            "telephone_number": "907-561-4362",
            "fax_number": "907-563-4362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY-VO",
        "first_name": "SHANNA",
        "middle_name": "NAOMI",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-21",
        "last_updated": "2021-08-27",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "AK",
            "license": "173495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.