Active NPI
Barry Lee Bertolette, N.P.
- Psychiatry Physician
- Shelby, NC
National Provider Identifier
1407848864
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 201451
- Practice address
- 618 North Morgan Street
Shelby, NC 28150-4439 - Phone
- (704) 480-1882
- Fax
- (704) 480-1832
- NPI assigned
- Aug 22, 2005
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 201451 | NC | |
| Primary Care Nurse Practitioner | 363LP2300X | 201451 | NC | |
| Psychiatry Physician | 2084P0800X | 201451 | NC | Primary |
Addresses
Primary practice location
618 North Morgan Street
Shelby, NC 28150-4439
Mailing address
PO Box 1418
Shelby, NC 28151-1418
Phone (704) 480-1882
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6605025 | Medicaid | NC | |
| 89014FP | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Foothills Consulting Associates LLC | Psychiatry | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Psychiatry Physician
- Shelby, NC
- NPI 1770624637
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1245974400000",
"number": "1407848864",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1418",
"city": "SHELBY",
"state": "NC",
"postal_code": "281511418",
"telephone_number": "704-480-1882",
"fax_number": "704-480-1832"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "618 NORTH MORGAN STREET",
"city": "SHELBY",
"state": "NC",
"postal_code": "281504439",
"telephone_number": "704-480-1882",
"fax_number": "704-480-1832"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERTOLETTE",
"first_name": "BARRY",
"middle_name": "LEE",
"credential": "N.P.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-22",
"last_updated": "2009-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "NC",
"license": "201451",
"primary": false
},
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "NC",
"license": "201451",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NC",
"license": "201451",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6605025",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "89014FP",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Shelby, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.