Individual provider Active NPI

Tina Marie Berg, M.A., CCC-A

  • Audiologist
  • Lewistown, MT
National Provider Identifier
1407906381
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AU1068 Issued in MT
Practice address
625 NE Main St
Suite 1
Lewistown, MT 59457-2084
Phone
(406) 538-5072
Fax
(406) 538-5059
NPI assigned
Jan 11, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AU1068 MT Primary

Addresses

Primary practice location

625 NE Main St
Suite 1
Lewistown, MT 59457-2084

Mailing address

625 NE Main St
Suite 1
Lewistown, MT 59457-2084
Phone (406) 538-5072

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040901000851 MT Practitioner - Qualified Audiologist 7012982077 Reassigns benefits to 1 organization
I20140718001512 TX Practitioner - Qualified Audiologist 7012982077 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

625 NE Main St
Lewistown, MT 59457-2084
Phone (406) 538-5072

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
AU1068MTMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
US Dept of HHS CurrentSince Apr 1, 2014 Accepting new patients
U S Health Dept of Health & Human Services CurrentSince Apr 1, 2014 Accepting new patients
Central Montana Hearing & Audiology, P.C. Audiologist CurrentSince Apr 30, 2003 Accepting new patients
US Health Dept of Health & Human Services Current Accepting new patients

Locations

669 Agency Main St
Harlem, MT 59526
Phone (406) 353-3100

625 NE Main St
Ste 1
Lewistown, MT 59457
Phone (406) 538-5072

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.

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407906381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 NE MAIN ST",
            "address_2": "SUITE 1",
            "city": "LEWISTOWN",
            "state": "MT",
            "postal_code": "594572084",
            "telephone_number": "406-538-5072",
            "fax_number": "406-538-5059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 NE MAIN ST",
            "address_2": "SUITE 1",
            "city": "LEWISTOWN",
            "state": "MT",
            "postal_code": "594572084",
            "telephone_number": "406-538-5072",
            "fax_number": "406-538-5059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "TINA",
        "middle_name": "MARIE",
        "credential": "M.A., CCC-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MT",
            "license": "AU1068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewistown, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.