Active NPI
Lauren K Berg, ARNP
- Nurse Practitioner
- Walla Walla, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- AP60992349
- Practice address
- 1024 S 2ND Ave
Walla Walla, WA 99362-4117 - Phone
- (509) 540-1759
- Fax
- (833) 450-5993
- NPI assigned
- Oct 21, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | AP60992349 | WA | Primary |
Addresses
Primary practice location
1024 S 2ND Ave
Walla Walla, WA 99362-4117
Mailing address
1351 Lowell Dr
Walla Walla, WA 99362-8820
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2190950 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211210001035 | WA | Practitioner - Nurse Practitioner | 5193115905 | Reassigns benefits to 3 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
105 S 3Rd Ave
Walla Walla, WA 99362-2848
Phone (509) 240-2554
Hospital & facility affiliations
- Providence St Mary Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 73 of 100
- Quality
- 100
- Improvement activities
- 40
- Cost
- 10
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP60992349 | WA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thrive Life Wellness PLLC | Current | Accepting new patients | |
| Atomic2 Dermatology PLLC | Nurse Practitioner | Current | Accepting new patients |
Locations
9221 Sandifur Pkwy
Ste A
Pasco, WA 99301
Phone (509) 233-7546
105 S 3rd Ave
Walla Walla, WA 99362
Phone (509) 240-2554
694 W Rose St
Walla Walla, WA 99362
Phone (509) 529-4676
1024 S 2nd Ave
Walla Walla, WA 99362
Phone (509) 529-4676
Organizations & group practices 3
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.
-
- Nurse Practitioner
- Walla Walla, WA
- NPI 1891363719
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Walla Walla, WA
- NPI 1386895886
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787270400000",
"number": "1508409780",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1351 LOWELL DR",
"city": "WALLA WALLA",
"state": "WA",
"postal_code": "993628820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1024 S 2ND AVE",
"city": "WALLA WALLA",
"state": "WA",
"postal_code": "993624117",
"telephone_number": "509-540-1759",
"fax_number": "833-450-5993"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERG",
"first_name": "LAUREN",
"middle_name": "K",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-21",
"last_updated": "2026-08-21",
"certification_date": "2026-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WA",
"license": "AP60992349",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2190950",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Walla Walla, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.