Individual provider Active NPI

Bill Wayne Berry Jr., M.D.

  • Otolaryngology Physician
  • Virginia Beach, VA
National Provider Identifier
1639179153
Registry record updated Oct 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
0101054182 Issued in VA
Practice address
1950 Glenn Mitchell Dr
Suite 310
Virginia Beach, VA 23456-0019
Phone
(757) 507-0340
Fax
(757) 507-0341
NPI assigned
Jul 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 0101054182 VA Primary
Otolaryngic Allergy Physician 207YX0602X 0101054182 VA

Addresses

Primary practice location

1950 Glenn Mitchell Dr
Suite 310
Virginia Beach, VA 23456-0019

Mailing address

1950 Glenn Mitchell Dr
Suite 310
Virginia Beach, VA 23456-0019
Phone (757) 507-0340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20060419000590 VA Practitioner - OtolaryngologyPractitioner - Allergy/ImmunologyPractitioner - Emergency Medicine 3375552342 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Allergy/Immunology
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bayview Physician Services PCGroup PAC ID 5597664201, 311 clinicians

Practice addresses (Care Compare)

713 Volvo Pkwy
Suite 101
Chesapeake, VA 23320-1614
Phone (757) 842-4110

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101054182VAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bayview Physician Services, PC CurrentSince Jul 10, 2023 Accepting new patients
Bayview Physician Services, PC CurrentSince Jul 10, 2023 Accepting new patients
Bayview Medical Center, Inc Past Accepting new patients
Georgia Nasal & Sinus Institute, PC Otolaryngology PastSince Sep 1, 2017 Accepting new patients
Chesapeake Ear, Nose & Throat Associates, P.C. Otolaryngology Past Accepting new patients

Locations

713 Volvo Pkwy
Ste 101
Chesapeake, VA 23320
Phone (757) 842-4115

3241 Western Branch Blvd
Chesapeake, VA 23321
Phone (757) 686-3500

3241 Western Branch Blvd
Ste A
Chesapeake, VA 23321

111 Mill Creek Pkwy
Chesapeake, VA 23323
Phone (757) 558-8210

Interoperability endpoints

  • Direct secure messaging: bill.berry@bayview.eclinicaldirectplus.com

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 and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1122422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351555200000",
    "number": "1639179153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 GLENN MITCHELL DR",
            "address_2": "SUITE 310",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234560019",
            "telephone_number": "757-507-0340",
            "fax_number": "757-507-0341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 GLENN MITCHELL DR",
            "address_2": "SUITE 310",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234560019",
            "telephone_number": "757-507-0340",
            "fax_number": "757-507-0341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "BILL",
        "middle_name": "WAYNE",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-27",
        "last_updated": "2012-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "VA",
            "license": "0101054182",
            "primary": true
        },
        {
            "code": "207YX0602X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": "VA",
            "license": "0101054182",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.