Individual provider Active NPI

Christopher De Berg, CNP

  • Nurse Practitioner
  • Sioux Falls, SD
National Provider Identifier
1689021537
Registry record updated Mar 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
CP001085 Issued in SD
Practice address
1210 W 18TH St
Suite G01
Sioux Falls, SD 57104-4651
Phone
(605) 328-2663
Fax
(605) 328-3772
NPI assigned
May 20, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X CP001085 SD Primary

Addresses

Primary practice location

1210 W 18TH St
Suite G01
Sioux Falls, SD 57104-4651

Mailing address

1210 W 18TH St
Suite G01
Sioux Falls, SD 57104-4651
Phone (605) 328-2663

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170126001774 SD Practitioner - Nurse Practitioner 1557643509 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Medical CenterGroup PAC ID 8325950215, 847 clinicians

Practice addresses (Care Compare)

1210 W 18TH St
Suite G01
Sioux Falls, SD 57104-4651
Phone (605) 328-2663

Hospital & facility affiliations

  • Sanford Usd Medical Center Hospital, Sioux Falls, SD, CCN 430027

Merit-based Incentive Payment System (MIPS)

Final score
84.78 of 100Reported as group
Quality
78.77
Promoting interoperability
100
Improvement activities
40
Cost
70.49

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Clinic CurrentSince Dec 18, 2016 Accepting new patients
Sanford Clinic CurrentSince Dec 18, 2016 Accepting new patients
Sanford Medical Center Nurse Practitioner CurrentSince Dec 18, 2016 Accepting new patients
Sanford Clinic Nurse Practitioner Current Accepting new patients
Sanford Clinic Nurse Practitioner Past Accepting new patients

Locations

4405 E 26th St
Sioux Falls, SD 57103
Phone (605) 328-9000

1210 W 18th St
Ste G01
Sioux Falls, SD 57104
Phone (605) 328-1395

1305 W 18th St
Sioux Falls, SD 57105
Phone (605) 312-7300

20 S Plum St
Vermillion, SD 57069
Phone (605) 624-2611

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": "1463702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488758400000",
    "number": "1689021537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 W 18TH ST",
            "address_2": "SUITE G01",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571044651",
            "telephone_number": "605-328-2663",
            "fax_number": "605-328-3772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 W 18TH ST",
            "address_2": "SUITE G01",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571044651",
            "telephone_number": "605-328-2663",
            "fax_number": "605-328-3772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE BERG",
        "first_name": "CHRISTOPHER",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-20",
        "last_updated": "2017-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SD",
            "license": "CP001085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.