Individual provider Active NPI

Kerri Berard

  • Speech-Language Pathologist
  • Fort Worth, TX
National Provider Identifier
1689042905
Registry record updated May 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
115010 Issued in TX
Practice address
100 N University Dr
Fort Worth, TX 76107-1360
Phone
(817) 814-2000
NPI assigned
Sep 3, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 115010 TX Primary

Addresses

Primary practice location

100 N University Dr
Fort Worth, TX 76107-1360

Mailing address

100 N University Dr
Fort Worth, TX 76107-1360

Other practice location 1

1106 N 155th St Ste B
Basehor, KS 66007-7100
Phone (913) 662-7071

Other identifiers 2

IdentifierTypeStateIssuer
48-1284001OtherKSCASE MAN./CARE COORD
659249401MedicaidTX

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

LicenseStateTypeSpecialty
115010TXMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1441238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653350400000",
    "number": "1689042905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N UNIVERSITY DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761071360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N UNIVERSITY DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761071360",
            "telephone_number": "817-814-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1106 N 155th St Ste B",
            "address_purpose": "LOCATION",
            "city": "Basehor",
            "state": "KS",
            "postal_code": "660077100",
            "country_code": "US",
            "telephone_number": "913-662-7071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERARD",
        "first_name": "KERRI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-03",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "115010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CASE MAN./CARE COORD",
            "identifier": "48-1284001",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "659249401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.