Individual provider Active NPI

Jill Marie Berg, M.P.T

  • Physical Therapist
  • West Des Moines, IA
National Provider Identifier
1447366158
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
02032 Issued in IA
Practice address
5950 University Ave Ste 385
West Des Moines, IA 50266-8216
Phone
(515) 875-9706
Fax
(515) 875-9707
NPI assigned
Aug 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 02032 IA Primary

Addresses

Primary practice location

5950 University Ave Ste 385
West Des Moines, IA 50266-8216

Mailing address

PO Box 424
Des Moines, IA 50302-0424
Phone (515) 875-9255

Other identifiers 1

IdentifierTypeStateIssuer
02032OtherIALICENSE #

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jillberg@tic.allscriptsdirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070118000093 IA Practitioner - Physical Therapist in Private Practice 0244231264 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Iowa Clinic PCGroup PAC ID 4082513742, 307 clinicians

Practice addresses (Care Compare)

5950 University Ave
West Des Moines, IA 50266-8216
Phone (515) 875-9100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
02032IAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Iowa Clinic, PC CurrentSince Jan 3, 2012 Accepting new patients
The Iowa Clinic PC CurrentSince Jan 3, 2012 Accepting new patients

Locations

509 N Madison St
Bloomfield, IA 52537
Phone (641) 664-2145

1005 Pennsylvania Ave
Ste 102A
Ottumwa, IA 52501
Phone (641) 684-2589

5950 University Ave
Ste 380
West Des Moines, IA 50266
Phone (515) 875-9902

5950 University Ave
Ste 385
West Des Moines, IA 50266

5950 University Ave
Ste 175
West Des Moines, IA 50266
Phone (515) 875-9908

5950 University Ave
Ste 285
West Des Moines, IA 50266
Phone (515) 875-9850

6800 Lake Dr
Ste 250
West Des Moines, IA 50266

7147 Vista Dr
Ste 150
West Des Moines, IA 50266
Phone (515) 875-9255

Interoperability endpoints

  • Direct secure messaging: jillberg@tic.allscriptsdirect.net

Organizations & group practices 2

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": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1447366158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 424",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503020424",
            "telephone_number": "515-875-9255",
            "fax_number": "515-875-9223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5950 UNIVERSITY AVE STE 385",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502668216",
            "telephone_number": "515-875-9706",
            "fax_number": "515-875-9707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "JILL",
        "middle_name": "MARIE",
        "credential": "M.P.T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-23",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "02032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "02032",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jillberg@tic.allscriptsdirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5950 University Ave",
            "address_2": "Ste 285",
            "city": "West Des Moines",
            "state": "IA",
            "country_code": "US",
            "postal_code": "50266",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2023; 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.