Jereme Dewayne Berryhill

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

102997 Issued in CA

Practice address

3150 Case Rd BLDG C
Perris, CA 92570-5552

Phone

(419) 383-3504

Fax

(419) 383-6127

NPI assigned

Jun 7, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1496793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536796800000",
    "number": "1669901286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15500 BAYLIS ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482381538",
            "telephone_number": "901-461-7221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3150 CASE RD BLDG C",
            "city": "PERRIS",
            "state": "CA",
            "postal_code": "925705552",
            "telephone_number": "419-383-3504",
            "fax_number": "419-383-6127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRYHILL",
        "first_name": "JEREME",
        "middle_name": "DEWAYNE",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-07",
        "last_updated": "2018-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "102997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Veronica Denay Bejarano
• Masum Abdul Khabir Bennerson, PRC
• Russle Calvinist Benson, PHARMD
• Brian Keith Bernard, PTA
• Rochelle Bernarte
• Alicia Betancur, MS
• BGM Medical Services Inc a Medical Corporation
• BGM Medical Services Inc a Medical Corporation
• Stephanie Ke Ahi Bias
• Edward S Bielecki

• All providers in Perris, CA
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.