NPIMap

Organization Active NPI

Berry Chiropractic Center

  • Rehabilitation Chiropractor
  • Frederick, MD
National Provider Identifier
1437331311
Registry record updated Mar 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
S01420 Issued in MD
Legal business name
BERRY CHIROPRACTIC CENTER
Practice address
176 Thomas Johnson Dr
#204
Frederick, MD 21702-4410
Phone
(301) 620-4100
Fax
(301) 420-1407
NPI assigned
Dec 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2012

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

Authorized official

Name
Mr. Donald Blake Berry, DCNPI 1952382004
Title
Owner
Phone
(301) 620-4100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NR0400X S01420 MD Primary

Addresses

Primary practice location

176 Thomas Johnson Dr
#204
Frederick, MD 21702-4410

Mailing address

176 Thomas Johnson Dr
#204
Frederick, MD 21702-4410
Phone (301) 620-4100

Other identifiers 4

IdentifierTypeStateIssuer
KP25BEOtherCAREFIRST BCBS MARYLAND
3831919OtherCIGNA
223239OtherMAMSI
W375-0001OtherCAREFIRST BCBS FEP

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1196640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330992000000",
    "number": "1437331311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 THOMAS JOHNSON DR",
            "address_2": "#204",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024410",
            "telephone_number": "301-620-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 THOMAS JOHNSON DR",
            "address_2": "#204",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024410",
            "telephone_number": "301-620-4100",
            "fax_number": "301-420-1407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERRY CHIROPRACTIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-03",
        "last_updated": "2012-03-06",
        "status": "A",
        "authorized_official_last_name": "BERRY",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "BLAKE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-620-4100",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "MD",
            "license": "S01420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS  MARYLAND",
            "identifier": "KP25BE",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3831919",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "223239",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS FEP",
            "identifier": "W375-0001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2012; 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.