Individual provider Active NPI

Heather Lyn Berry, NP

  • Family Nurse Practitioner
  • Gulfport, MS
National Provider Identifier
1780148874
Registry record updated Jan 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
903136 Issued in MS
Practice address
4500 13TH St
Gulfport, MS 39501-2515
Phone
(228) 575-2020
NPI assigned
Jan 23, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2019

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 903136 MS Primary

Addresses

Primary practice location

4500 13TH St
Gulfport, MS 39501-2515

Mailing address

4500 13TH St
Gulfport, MS 39501-2515
Phone (228) 575-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190517000431 MS Practitioner - Nurse Practitioner 2668715418 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hospital at GulfportGroup PAC ID 2466524012, 473 clinicians

Practice addresses (Care Compare)

1104 Broad Ave
Gulfport, MS 39501-2414
Phone (228) 822-6811

1110 Broad Ave
Suite 500
Gulfport, MS 39501-8902
Phone (228) 575-2588

1110 Broad Ave
Suite 700
Gulfport, MS 39501-8908
Phone (228) 864-0314

1202 Broad Ave
Gulfport, MS 39501-2426
Phone (228) 822-9360

1203 Broad Ave
Gulfport, MS 39501-2489
Phone (228) 868-5555

1206 31St Ave
Gulfport, MS 39501-1804
Phone (228) 864-0008

1312 44TH Ave
Gulfport, MS 39501-2552
Phone (228) 867-5012

1340 Broad Ave
Gulfport, MS 39501-2404

1340 Broad Ave
Gulfport, MS 39501-2445

1340 Broad Ave
Gulfport, MS 39501-2460

1340 Broad Ave
Gulfport, MS 39501-2464

1340 Broad Ave
Gulfport, MS 39501-2465

1340 Broad Ave
Suite 410
Gulfport, MS 39501-2459
Phone (228) 867-5202

1391 Broad Ave
Suite a
Gulfport, MS 39501-2419
Phone (228) 863-8868

1397 Broad Ave
Gulfport, MS 39501-2419
Phone (228) 575-1945

1404 44TH Ave
Gulfport, MS 39501-2554
Phone (228) 575-2870

1408 44TH Ave
Gulfport, MS 39501-2554
Phone (228) 575-1777

1801 23Rd Ave
Gulfport, MS 39501-2964

2309 15TH St
Gulfport, MS 39501-2027

4215 15TH St
Gulfport, MS 39501-2523
Phone (228) 863-5211

4300 B W Railroad St
Gulfport, MS 39501-2568
Phone (228) 822-6811

4333 15TH St
Suite a
Gulfport, MS 39501-2525
Phone (228) 863-4000

4500 13TH St
Gulfport, MS 39501-2515
Phone (228) 867-3152

4500 13TH St
Gulfport, MS 39501-2569

4500 W Railroad St
Gulfport, MS 39501-2479
Phone (228) 863-8836

Hospital & facility affiliations

  • Memorial Hospital at Gulfport Hospital, Gulfport, MS, CCN 250019

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
903136MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital at Gulfport Current Accepting new patients
Memorial Hospital at Gulfport CurrentSince Mar 15, 2019 Accepting new patients
Memorial Hospital at Gulfport CurrentSince Mar 15, 2019 Accepting new patients

Locations

1104 Broad Ave
Gulfport, MS 39501
Phone (228) 343-4057

1340 Broad Ave
Ste 440
Gulfport, MS 39501
Phone (228) 867-4856

4500 13th St
#P
Gulfport, MS 39501
Phone (228) 865-3451

4500 13th St
Gulfport, MS 39501
Phone (228) 236-3872

Organizations & group practices 4

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.

Hospital & facility affiliations 60

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 60

NPI Registry JSON

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

{
    "created_epoch": "1548201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548201600000",
    "number": "1780148874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 13TH ST",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012515",
            "telephone_number": "228-575-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 13TH ST",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012515",
            "telephone_number": "228-575-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "HEATHER",
        "middle_name": "LYN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-23",
        "last_updated": "2019-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "903136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

Verify at the official NPI Registry.