Nicole R Berger, MSPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT05322 Issued in TN

Practice address

600 N Holtzclaw Ave
Ste 100
Chattanooga, TN 37404-1242

Phone

(423) 622-0500

Fax

(423) 622-0564

NPI assigned

Oct 6, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Wave Physical Therapy, Incorporated

  • Pediatric Physical Therapist
  • Chattanooga, TN
  • NPI 1932291002
  NPD (past) Authorized official
• Team Centers Inc

  • Psychologist
  • Chattanooga, TN
  • NPI 1992793012
  NPD (past)

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417945205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4204 BENTON DR",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374061256",
            "telephone_number": "423-227-0386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N HOLTZCLAW AVE",
            "address_2": "STE 100",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041242",
            "telephone_number": "423-622-0500",
            "fax_number": "423-622-0564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGER",
        "first_name": "NICOLE",
        "middle_name": "R",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "PT05322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3659241",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kirah Benton
• Madison McLayne Nolen Benton, MD
• Oliver Benton III, M.D.
• George Henry Bercaw, M.A.
• John Barton Berg Jr., DDS
• Cameron Jackson Bergeron, MD
• Kaitlyn Patricia Bergeron
• Kelly L Bergmann, RBT
• Monica Beri, M.D.
• Parker Allen Berlekamp

• Physical Therapist in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Physical Therapist in Tennessee

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.