Jae Berry, RN

Primary specialty

Case Management Registered NurseTaxonomy code 163WC0400X

License

4704403446 Issued in MI

Practice address

100 Riverfront Dr Apt 1606
Detroit, MI 48226-4539

Phone

(313) 444-3489

Fax

(586) 408-6000

NPI assigned

Sep 15, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Ms. Jaqetta D Berry Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1757894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757894400000",
    "number": "1639040413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 RIVERFRONT DR APT 1606",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482264539",
            "telephone_number": "313-444-3489",
            "fax_number": "586-408-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 RIVERFRONT DR APT 1606",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482264539",
            "telephone_number": "313-444-3489",
            "fax_number": "586-408-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "JAE",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-15",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "202K00000X",
            "taxonomy_group": "",
            "desc": "Phlebology",
            "state": "MI",
            "license": "4704403446",
            "primary": false
        },
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "MI",
            "license": "4704403446",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "MI",
            "license": "4704403446",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAQETTA",
            "last_name": "BERRY",
            "middle_name": "D",
            "prefix": "MS.",
            "credential": "RN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Nadia Hussein Berro, PHYSICIAN ASSISTANT
• Berry Adult Foster Care Homes Inc (One on One Respite Care)
• Felecia Berry, LMSW
• Felicia Lenore Berry, MA
• Fouad Berry, MD
• Lacresha Berry
• Madeena Berry
• Matthew G Berry
• Michelle Berry
• Miracle Nakayla Berry

• Case Management Registered Nurse in Detroit, MI
• Providers in Detroit, MI by specialty
• Case Management Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2025; 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.