Individual provider Active NPI

Cheryl Berry, DC

  • Chiropractor
  • Kent, WA
National Provider Identifier
1720115652
Registry record updated Jul 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00033769 Issued in WA
Practice address
26461 104TH Ave SE
Kent, WA 98030-7668
Phone
(253) 852-4532
NPI assigned
Feb 27, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH00033769 WA Primary

Addresses

Primary practice location

26461 104TH Ave SE
Kent, WA 98030-7668

Mailing address

26461 104TH Ave SE
Kent, WA 98030-7668
Phone (253) 852-4532

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060110001032 WA Practitioner - Chiropractic 5193748648 Practice locations: Black Diamond, WA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1999
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

26461 104TH Ave SE
Kent, WA 98030-7668

30741 3Rd Ave
Suite 162
Black Diamond, WA 98010-9791
Phone (253) 852-4532

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341878400000",
    "number": "1720115652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26461 104TH AVE SE",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980307668",
            "telephone_number": "253-852-4532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26461 104TH AVE SE",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980307668",
            "telephone_number": "253-852-4532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "CHERYL",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2012-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00033769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kent, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.