Nicole H Berk, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D021683 Issued in NJ

Practice address

61 S Black Horse Pike
Blackwood, NJ 08012-2952

Phone

(856) 227-2727

NPI assigned

Jan 25, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241049600000",
    "number": "1508911702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 S BLACK HORSE PIKE",
            "city": "BLACKWOOD",
            "state": "NJ",
            "postal_code": "080122952",
            "telephone_number": "856-227-2727",
            "fax_number": "856-227-6737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 S BLACK HORSE PIKE",
            "city": "BLACKWOOD",
            "state": "NJ",
            "postal_code": "080122952",
            "telephone_number": "856-227-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERK",
        "first_name": "NICOLE",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2009-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "D021683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frank Milton Banks, DO
• Eric Marc Barbera, DC
• Beacon Specialized Living New Jersey, Inc.
• Beneficial Home Care
• Brenda J Bennett, DPT
• Kelly Elizabeth Bernal
• Shannon Bishop
• Black Horse Pike Regional School District
• Catherine Anne Boos, D.M.D.
• Bouncing Back LLC

• General Practice Dentistry in Blackwood, NJ
• Providers in Blackwood, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.