Individual provider Active NPI

Mary Charlene Berg, CRNA

  • Certified Registered Nurse Anesthetist
  • Denton, TX
National Provider Identifier
1477530871
Registry record updated Feb 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
670102 Issued in TX
Practice address
3535 S Interstate 35 E
Denton, TX 76210-6850
Phone
(940) 384-3270
Fax
(940) 384-4723
NPI assigned
Dec 27, 2005
Sex
Female
Sole proprietor
No

Organizations & group practices 11

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.

Hospital & facility affiliations 2

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

Medicare Care Compare profile

Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthtexas Provider Network (2,535 clinicians)
Sound Physicians Anesthesiology of Texas PLLC (134 clinicians)
Spine Team Texas PA (27 clinicians)

Practice addresses (Care Compare)

1400 8TH Ave
Fort Worth, TX 76104-4110

1500 S Main St
Fort Worth, TX 76104-4917
Phone (817) 702-3431

1545 E Southlake Blvd
Suite 100
Southlake, TX 76092-6465
Phone (817) 442-9300

5408 Colleyville Blvd
Colleyville, TX 76034-5833
Phone (817) 498-9920

Hospital & facility affiliations

  • JPS Health Network Hospital · Fort Worth, TX · CCN 450039
  • Baylor Scott and White All Saints Medical Center Hospital · Fort Worth, TX · CCN 450137

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20040408000702 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 3678566163 Reassigns benefits to 7 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
670102TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia, PA Nurse Anesthetist, Certified Registered Current
since Feb 1, 2008
Accepting new patients
Valiant Anesthesia Associates, PLLC Current
since Feb 1, 2020
Accepting new patients
Spine Team Texas, PA Current
since Dec 1, 2019
Accepting new patients
Northstar Anesthesia II PA Nurse Anesthetist, Certified Registered Current
since Aug 14, 2018
Accepting new patients
Spine Team Texas, PA Current
since Dec 1, 2019
Accepting new patients
Spine Team Texas PA Current Accepting new patients
Sound Physicians Anesthesiology of Texas PLLC Current
since Apr 1, 2021
Accepting new patients
Eagle Anesthesia PLLC Current
since Jun 2, 2020
Accepting new patients
Central Anesthesia Associates, LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Presbyterian Hospital of Dallas Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

2000 E Lamar Blvd
Ste 400
Arlington, TX 76006
Phone (817) 861-3994

11801 South Fwy
Burleson, TX 76028
Phone (817) 551-2738

7101 S Padre Island Dr
Corpus Christi, TX 78412
Phone (361) 761-1400

3930 Crutcher St
Dallas, TX 75246
Phone (214) 520-8235

5327 N Central Expy
Ste 200
Dallas, TX 75205
Phone (214) 520-8235

14850 Quorum Dr
Ste 400
Dallas, TX 75254
Phone (214) 801-1879

1500 S Main St
Ft Worth, TX 76104
Phone (817) 921-3431

909 9th Ave
Ft Worth, TX 76104
Phone (817) 336-6060

2001 W Rosedale St
Ft Worth, TX 76104
Phone (817) 877-4777

1400 8th Ave
Ft Worth, TX 76104
Phone (817) 922-1559

811 S Central Expy
Ste 103
Richardson, TX 75080
Phone (972) 310-7121

3142 Horizon Rd
Ste 100
Rockwall, TX 75032
Phone (682) 651-1908

1545 E Southlake Blvd
Ste 100
Southlake, TX 76092

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 670102 TX Primary

Addresses

NPPES NPI Registry

Primary practice location

3535 S Interstate 35 E
Denton, TX 76210-6850

Mailing address

PO Box 650426
Dallas, TX 75265-0426
Phone (972) 233-1999

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
162756402MedicaidTX

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 17, 2009.

{
    "created_epoch": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234828800000",
    "number": "1477530871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650426",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752650426",
            "telephone_number": "972-233-1999",
            "fax_number": "972-233-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 S INTERSTATE 35 E",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762106850",
            "telephone_number": "940-384-3270",
            "fax_number": "940-384-4723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "MARY",
        "middle_name": "CHARLENE",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-27",
        "last_updated": "2009-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "670102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "162756402",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2009; 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.