Active NPI
Brian Berg
- Athletic Trainer
- Apopka, FL
National Provider Identifier
1679989149
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 1874
- Practice address
- 1210 Crossfield Dr
Apopka, FL 32703-1540 - Phone
- (407) 921-3968
- NPI assigned
- Jul 6, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Basic Emergency Medical Technician | 146N00000X | EMT 539865 | FL | |
| Athletic Trainer | 2255A2300X | 1874 | AL | Primary |
Addresses
Primary practice location
1210 Crossfield Dr
Apopka, FL 32703-1540
Mailing address
1210 Crossfield Dr
Apopka, FL 32703-1540
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| E3033546 | Other | FL | NREMT |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| EMT 539865 | FL | MD | Basic Emergency Medical Technician |
| 1874 | AL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1469750400000",
"number": "1679989149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1210 CROSSFIELD DR",
"city": "APOPKA",
"state": "FL",
"postal_code": "327031540"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1210 CROSSFIELD DR",
"city": "APOPKA",
"state": "FL",
"postal_code": "327031540",
"telephone_number": "407-921-3968"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERG",
"first_name": "BRIAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-07-06",
"last_updated": "2016-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "146N00000X",
"taxonomy_group": "",
"desc": "Emergency Medical Technician, Basic",
"state": "FL",
"license": "EMT 539865",
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "AL",
"license": "1874",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NREMT",
"identifier": "E3033546",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Apopka, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.