Active NPI
Heather Berry, ATC
- Athletic Trainer
- Kamuela, HI
National Provider Identifier
1730681487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT-56
- Practice address
- 65-1692 Kohala Mountain Rd
Kamuela, HI 96743-8476 - Phone
- (808) 881-4061
- NPI assigned
- Mar 7, 2018
- Last updated
- Mar 7, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT-56 | HI | Primary |
Addresses
Primary practice location
65-1692 Kohala Mountain Rd
Kamuela, HI 96743-8476
Mailing address
75-5660 Kopiko St
Ste C-7 #339
Kailua-Kona, HI 96740
Phone (808) 283-8858
Other names 1
- Heather Mock
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
| License | State | Type | Specialty |
|---|---|---|---|
| AT-56 | HI | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1520380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1520380800000",
"number": "1730681487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "75-5660 KOPIKO ST",
"address_2": "STE C-7 #339",
"city": "KAILUA-KONA",
"state": "HI",
"postal_code": "96740",
"telephone_number": "808-283-8858"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "65-1692 KOHALA MOUNTAIN RD",
"city": "KAMUELA",
"state": "HI",
"postal_code": "967438476",
"telephone_number": "808-881-4061"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERRY",
"first_name": "HEATHER",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-03-07",
"last_updated": "2018-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "HI",
"license": "AT-56",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "HEATHER",
"last_name": "MOCK",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Kamuela, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.