NPIMap

Individual provider Active NPI

David Douglas Berg, D.O.

  • Emergency Medicine Physician
  • Wyoming, MI
National Provider Identifier
1457309767
Registry record updated Sep 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
5101013441 Issued in MI
Practice address
5900 Byron Center SW
Metro Health Hospital
Wyoming, MI 49519
Phone
(616) 252-7123
NPI assigned
May 5, 2006
Last updated
Sep 4, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 5101013441 MI Primary

Addresses

Primary practice location

5900 Byron Center SW
Metro Health Hospital
Wyoming, MI 49519

Mailing address

PO Box 2184
Certified Emergency Medicine Specialists, PC
Grand Rapids, MI 49501-2184
Phone (616) 363-7867

Other identifiers 1

IdentifierTypeStateIssuer
4413279MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, IN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040628000014 MI Practitioner - Emergency MedicinePractitioner - Internal Medicine 7214913557 Reassigns benefits to 3 organizations
I20241210002311 IN Practitioner - Emergency Medicine 7214913557 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clarksville Emergency Group PCGroup PAC ID 6507277423, 149 clinicians
Certified Emergency Medicine Specialists PCGroup PAC ID 6204802895, 14 clinicians

Practice addresses (Care Compare)

1010 W State Rd
2 Franciscan Beacon Hospital Icp
La Porte, IN 46350-5465
Phone (219) 575-6700

5900 Byron Ctr Ave SW
Wyoming, MI 49519-9606
Phone (616) 252-7200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Clarksville Emergency Group, PC Emergency Medicine CurrentSince Nov 5, 2024 Accepting new patients
Certified Emergency Medicine Specialists, PC CurrentSince Jul 14, 2002 Accepting new patients
Northern Michigan Emergency Physicians, LLP Emergency Medicine CurrentSince Mar 5, 2023 Accepting new patients
Metropolitan Hospital CurrentSince Feb 2, 2016 Accepting new patients
Metropolitan Hospital CurrentSince Feb 2, 2016 Accepting new patients
Northern Michigan Emergenc Physicians, LLP Emergency Medicine CurrentSince Mar 5, 2023 Accepting new patients
Spectrum Health United Past Accepting new patients

Locations

770 Indian Boundary Rd
Chesterton, IN 46304
Phone (219) 595-0630

1141 Hospital Dr NW
Corydon, IN 47112
Phone (812) 738-7830

1010 W State Road 2
La Porte, IN 46350
Phone (219) 575-6700

200 Corporate Blvd
Lafayette, LA 70508

3401 Ludington St
Escanaba, MI 49829
Phone (906) 786-3311

4055 Cascade Rd SE
Ste 100
Grand Rapids, MI 49546
Phone (616) 252-4010

4433 Byron Center Ave SW
Wyoming, MI 49519
Phone (616) 530-2846

5900 Byron Center Ave SW
Wyoming, MI 49519
Phone (616) 252-3243

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252022400000",
    "number": "1457309767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2184",
            "address_2": "CERTIFIED EMERGENCY MEDICINE SPECIALISTS, PC",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495012184",
            "telephone_number": "616-363-7867",
            "fax_number": "616-363-9432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 BYRON CENTER SW",
            "address_2": "METRO HEALTH HOSPITAL",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "49519",
            "telephone_number": "616-252-7123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "DAVID",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2009-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101013441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4413279",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MI

Sources for this page

Verify at the official NPI Registry.