NPIMap

Individual provider Active NPI

Bethany Lynn Berger, CRNP

  • Family Nurse Practitioner
  • Queenstown, MD
National Provider Identifier
1730440165
Registry record updated Apr 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R178016 Issued in MD
Practice address
125 Shoreway Drive
Suite 120
Queenstown, MD 21658
Phone
(410) 827-4001
NPI assigned
Jun 1, 2012
Last updated
Apr 28, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R178016 MD Primary

Addresses

Primary practice location

125 Shoreway Drive
Suite 120
Queenstown, MD 21658

Mailing address

125 Shoreway Drive
Suite 120
Queenstown, MD 21658
Phone (410) 827-4001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121214000140 MD Practitioner - Nurse Practitioner 7810941028 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Stevensville, MD 21666
Phone (443) 786-5154

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Care Solutions LLC Family CurrentSince Oct 2, 2023 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: bethany.berger@618289420500996.direct.elationemr.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1338508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461801600000",
    "number": "1730440165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 SHOREWAY DRIVE",
            "address_2": "SUITE 120",
            "city": "QUEENSTOWN",
            "state": "MD",
            "postal_code": "21658",
            "telephone_number": "410-827-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 SHOREWAY DRIVE",
            "address_2": "SUITE 120",
            "city": "QUEENSTOWN",
            "state": "MD",
            "postal_code": "21658",
            "telephone_number": "410-827-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGER",
        "first_name": "BETHANY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-01",
        "last_updated": "2016-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R178016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queenstown, MD

Sources for this page

Verify at the official NPI Registry.