Individual provider Active NPI

Lauren K Berg, ARNP

  • Nurse Practitioner
  • Walla Walla, WA
National Provider Identifier
1508409780
Registry record updated Aug 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP60992349 Issued in WA
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

Updated by the provider on Aug 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
2190950MedicaidWA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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 Hospital, Walla Walla, WA, CCN 500002

Merit-based Incentive Payment System (MIPS)

Final score
73 of 100Reported as group
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

LicenseStateTypeSpecialty
AP60992349WAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Life Wellness PLLC CurrentSince Aug 18, 2025 Accepting new patients
Atomic2 Dermatology PLLC Nurse Practitioner CurrentSince Apr 1, 2024 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.

Hospital & facility affiliations 1

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": "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

Verify at the official NPI Registry.