Koni Berreth, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

211-SLP Issued in SD

Practice address

3810 Jackson Blvd
Rapid City, SD 57702-3246

Phone

(605) 484-2303

NPI assigned

Oct 3, 2019

Last updated

Oct 3, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in SD

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dakota Speech and Swallow CenterGroup PAC ID 7214398239, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Locations

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.

• Dakota Speech and Swallow Center

  • Speech-Language Pathologist
  • Rapid City, SD
  • NPI 1144954678
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1570060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570060800000",
    "number": "1659912400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3810 JACKSON BLVD",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577023246",
            "telephone_number": "605-484-2303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3810 JACKSON BLVD",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577023246",
            "telephone_number": "605-484-2303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRETH",
        "first_name": "KONI",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-03",
        "last_updated": "2019-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SD",
            "license": "211-SLP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyler Bergstrom
• Gail Bernard
• Carey L Berndt, P.T.
• Shana S Bernhard, MD
• Ashley Bernhardt
• Berry Speech Therapy
• Brenda Berry, NP FNP
• Jeanne M. Berry, MD
• Johnathon Allen Berry, DO
• Linda M. Berry, B.S.

• Speech-Language Pathologist in Rapid City, SD
• Providers in Rapid City, SD by specialty
• Speech-Language Pathologist in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.