Individual provider Active NPI

Mark Robert Berg

  • Physical Therapy Assistant
  • Murfreesboro, TN
National Provider Identifier
1700738416
Registry record updated Feb 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
4485 Issued in TN
Practice address
1927 Memorial Blvd
Murfreesboro, TN 37129-1545
Phone
(615) 904-9111
NPI assigned
Feb 13, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 4485 TN Primary

Addresses

Primary practice location

1927 Memorial Blvd
Murfreesboro, TN 37129-1545

Mailing address

1927 Memorial Blvd
Murfreesboro, TN 37129-1545
Phone (615) 904-9111

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
4485TNMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1770940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770940800000",
    "number": "1700738416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1927 MEMORIAL BLVD",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371291545",
            "telephone_number": "615-904-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1927 MEMORIAL BLVD",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371291545",
            "telephone_number": "615-904-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "MARK",
        "middle_name": "ROBERT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-02-13",
        "last_updated": "2026-02-13",
        "certification_date": "2026-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TN",
            "license": "4485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murfreesboro, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2026; 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.