Kent Berry, PH.D

Primary specialty

PsychologistTaxonomy code 103T00000X

License

20042675A Issued in IN

Practice address

8424 Naab Road Building 1
Suite 1L
Indianapolis, IN 46260

Phone

(317) 338-7780

NPI assigned

Dec 3, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

St Vincent Medical Group Inc 728 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kent.berry.1@7598.direct.athenahealth.com

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.

• St. Vincent Medical Group, Inc.

  • Orthopaedic Surgery Physician
  • Winchester, IN
  • NPI 1144513375

  IN

  Medicare reassignment Care Compare group NPD
• St. Vincent Medical Group, Inc.

  • Rural Health Clinic/Center
  • Winchester, IN
  • NPI 1225301740
  Care Compare group
• St. Vincent Medical Group, Inc.

  • Rural Health Clinic/Center
  • North Vernon, IN
  • NPI 1376816975
  Care Compare group
• St. Vincent Medical Group, Inc.

  • Health Educator
  • Indianapolis, IN
  • NPI 1790317964
  Care Compare group
• St. Vincent Medical Group, Inc.

  • Rural Health Clinic/Center
  • Union City, IN
  • NPI 1871866384
  Care Compare group
• St. Vincent Medical Group, Inc.

  • Internal Medicine Physician
  • Carmel, IN
  • NPI 1811881527
  NPD
• Extended Care Specialists, Inc

  • Family Medicine Physician
  • Fort Wayne, IN
  • NPI 1669873733
  NPD (past)

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

{
    "created_epoch": "1386028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653350400000",
    "number": "1730510686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8424 NAAB ROAD BUILDING 1",
            "address_2": "SUITE 1L",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601954",
            "telephone_number": "317-338-7780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8424 NAAB ROAD BUILDING 1",
            "address_2": "SUITE 1L",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46260",
            "telephone_number": "317-338-7780"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "321South Main Street",
            "address_purpose": "LOCATION",
            "city": "New Castle",
            "state": "IN",
            "postal_code": "47362",
            "country_code": "US",
            "telephone_number": "765-529-3370",
            "fax_number": "765-529-7269",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3512 Stellhorn Rd",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468154631",
            "country_code": "US",
            "telephone_number": "512-575-8028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERRY",
        "first_name": "KENT",
        "name_prefix": "Mr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-12-03",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IN",
            "license": "20042675A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200077810A",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kent.berry.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St. Vincent Medical Group, Inc.",
            "address_1": "8424 Naab Road Building 1",
            "address_2": "Suite 1L",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Darla Jo Berry, CNM
• Elizabeth Berry
• Jennifer Berry, PA-C
• Jennifer M Berry, NP
• Katelin Sullivan Berry, PA
• Lakyah Berry
• Michele L Berry
• Natalie Berry, RBT
• Rana Snipe Berry, MD
• Rebecca Christine Berry

• All providers in Indianapolis, IN
• Psychologist in Indiana

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.