Grover Berry III, AA MANAGEMENT

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

Practice address

3660 N Rancho Dr Ste 113
Las Vegas, NV 89130-3188

Phone

(702) 982-2928

NPI assigned

Jul 28, 2014

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Associate of Arts

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

{
    "created_epoch": "1406505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406505600000",
    "number": "1578971065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3360 N RANCHO DR. STE.113",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89130",
            "telephone_number": "702-982-2928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3660 N RANCHO DR STE 113",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891303188",
            "telephone_number": "702-982-2928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "GROVER",
        "name_suffix": "III",
        "credential": "AA MANAGEMENT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-28",
        "last_updated": "2014-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittani Berry
• Carmela Delynn Berry
• Charles E Berry III, DMD
• Cynthia A Berry, RN
• Garrett Warner Berry, DMD
• Jamelle Berry
• Jennifer Elizabeth Berry
• Kartaysa Taymee Berry
• Kashiya Berry
• Kathryn Berry

• Clinical Neuropsychologist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Clinical Neuropsychologist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.