Tod L Berg, M.D.

Key facts

NPI

1497713648

Entity type

Individual (NPI type 1)

Primary specialty

Family Medicine Physician 207Q00000X

License

264477-1205 (UT)

Practice address

1467 S Highway 40
Heber, UT 84032-3522

Phone

(435) 654-6321

Fax

(435) 654-6364

NPI assigned

May 3, 2006

Sex

Male

Sole proprietor

Yes

Organizations & group practices 5

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.

• Ihc Health Services Inc Multi-Specialty Clinic/Center · Murray, UT · NPI 1629260880
  Medicare reassignment NPD FAMILY MEDICINE · UT
• Ihc Health Services Inc Multi-Specialty Clinic/Center · Sandy, UT · NPI 1942325154
  Medicare reassignment NPD UT
• Ihc Health Services Inc Pediatrics Physician · Salt Lake City, UT · NPI 1003255464
  NPD
• Ihc Health Services Inc Otolaryngology Physician · Ogden, UT · NPI 1598892671
  NPD
• Ihc Health Services, Inc. Psychiatry Physician · St George, UT · NPI 1023843844
  NPD

Medicare participation

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

Practice roles

Locations

Specialties & licenses

Addresses

Electronic endpoints

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 30, 2021.

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632960000000",
    "number": "1497713648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1467 S HIGHWAY 40",
            "city": "HEBER",
            "state": "UT",
            "postal_code": "840323522",
            "telephone_number": "435-654-6321",
            "fax_number": "435-654-6364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1467 S HIGHWAY 40",
            "city": "HEBER",
            "state": "UT",
            "postal_code": "840323522",
            "telephone_number": "435-654-6321",
            "fax_number": "435-654-6364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "TOD",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2021-09-30",
        "certification_date": "2021-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "264477-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tod.berg@direct.imail.org",
            "affiliation": "N",
            "address_1": "1467 S Highway 40",
            "city": "Heber",
            "state": "UT",
            "country_code": "US",
            "postal_code": "840323522",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Heber, UT

• Kelly C Cook
• Nicole Davis, FNP-C, ENP-C
• Ron T Dummar, D.C.
• Michael Heder, DO
• Ihc Health Services, Inc

All providers in Heber, UT · Family Medicine Physician in Utah