Individual provider Active NPI

Ronald Ray Berges, DO

  • Psychiatry Physician
  • Ottumwa, IA
National Provider Identifier
1598860405
Registry record updated Dec 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
1304996 Issued in IA
Practice address
1112 N Van Buren Ave
Ottumwa, IA 52501-6416
Phone
(641) 684-7744
NPI assigned
Sep 14, 2006
Last updated
Dec 21, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 1304996 IA Primary

Addresses

Primary practice location

1112 N Van Buren Ave
Ottumwa, IA 52501-6416

Mailing address

1112 N Van Buren Ave
Ottumwa, IA 52501-6416
Phone (641) 684-7744

Other identifiers 4

IdentifierTypeStateIssuer
2776088MedicaidIA
43269OtherIAINDIVIDUAL PROVIDER #
421525352-01OtherIAINDIVIDUAL PROVIDER #
14660OtherIAINDIVIDUAL PROVIDER #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050512000925 IA Practitioner - Psychiatry 4486646312 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
1304996IAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Human Services-Cherokee CurrentSince Jun 25, 2019 Accepting new patients
Ottumwa Mental Wellness Center Past Accepting new patients
Southern Iowa Mental Health Center Past Accepting new patients
Ottumwa Psychiatric Clinic PC Psychiatry Past Accepting new patients
Southern Iowa Mental Health Center Past Accepting new patients

Locations

1251 W Cedar Loop
Cherokee, IA 51012
Phone (712) 225-2594

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198195200000",
    "number": "1598860405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 N VAN BUREN AVE",
            "city": "OTTUMWA",
            "state": "IA",
            "postal_code": "525016416",
            "telephone_number": "641-684-7744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 N VAN BUREN AVE",
            "city": "OTTUMWA",
            "state": "IA",
            "postal_code": "525016416",
            "telephone_number": "641-684-7744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGES",
        "first_name": "RONALD",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2007-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IA",
            "license": "1304996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2776088",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL PROVIDER #",
            "identifier": "43269",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL PROVIDER #",
            "identifier": "421525352-01",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL PROVIDER #",
            "identifier": "14660",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ottumwa, IA

Sources for this page

Verify at the official NPI Registry.