Active NPI
Eva A Berardelli, M.D.
- Rehabilitation Practitioner
- Longmont, CO
National Provider Identifier
1629165469
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- License
- 25586
- Practice address
- 2030 Mountain View Ave
Longmont, CO 80501-3178 - Phone
- (303) 709-9772
- Fax
- (303) 652-0468
- NPI assigned
- Oct 5, 2006
- Last updated
- Jan 23, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | 25586 | CO | Primary |
Addresses
Primary practice location
2030 Mountain View Ave
Longmont, CO 80501-3178
Mailing address
PO Box 614
Niwot, CO 80544-0614
Phone (303) 709-7792
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25586 | CO | MD | Rehabilitation Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1327276800000",
"number": "1629165469",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 614",
"city": "NIWOT",
"state": "CO",
"postal_code": "805440614",
"telephone_number": "303-709-7792"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2030 MOUNTAIN VIEW AVE",
"city": "LONGMONT",
"state": "CO",
"postal_code": "805013178",
"telephone_number": "303-709-9772",
"fax_number": "303-652-0468"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERARDELLI",
"first_name": "EVA",
"middle_name": "A",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-05",
"last_updated": "2012-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": "CO",
"license": "25586",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Longmont, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.