Berg Medical Clinic PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

SD 4247 Issued in SD

Legal business name

BERG MEDICAL CLINIC PC

Practice address

221 Calumet Ave SW
De Smet, SD 57231

Phone

(605) 854-9100

Fax

(605) 854-9238

NPI assigned

Dec 27, 2007

Last updated

Jan 3, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Janelle Schubloom

Title

Office Manager

Phone

(605) 854-9100

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1198713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199318400000",
    "number": "1770767782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 CALUMET AVE SW",
            "city": "DE SMET",
            "state": "SD",
            "postal_code": "57231",
            "telephone_number": "605-854-9100",
            "fax_number": "605-854-9238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 CALUMET AVE SW",
            "city": "DE SMET",
            "state": "SD",
            "postal_code": "57231",
            "telephone_number": "605-854-9100",
            "fax_number": "605-854-9238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERG MEDICAL CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-27",
        "last_updated": "2008-01-03",
        "status": "A",
        "authorized_official_last_name": "SCHUBLOOM",
        "authorized_official_first_name": "JANELLE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "605-854-9100"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "SD 4247",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SD BLUE SHIELD",
            "identifier": "4996058",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5602487",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alese M Allerdings, M.D.
• Avera Queen of Peace (Avera Hoek Medical Clinic)
• Avera Queen of Peace (Avera De Smet Memorial Hospital)
• Avera Queen of Peace (Avera De Smet Memorial Hospital)
• Avera Queen of Peace (Avera De Smet Clinic)
• John Andrew Berg, MD
• Buchele Drug
• Donald Kraig Buchele
• De Smet Emergency Rescue Unit Inc.
• De Smet School District

• Family Medicine Physician in De Smet, SD
• Providers in De Smet, SD by specialty
• Family Medicine Physician in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2008; 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.