Jeffery C Berg

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

P161592443 Issued in WA

Practice address

730 N Hamilton St
Spokane, WA 99202-2045

Phone

(509) 468-7686

Fax

(509) 808-2164

NPI assigned

Sep 20, 2024

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1726790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1780401901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 N HAMILTON ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992022045",
            "telephone_number": "509-468-7686",
            "fax_number": "509-808-2164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 N HAMILTON ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992022045",
            "telephone_number": "509-468-7686",
            "fax_number": "509-808-2164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "JEFFERY",
        "middle_name": "C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-09-20",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "P161592443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michele Marie Benz, L.M.P.
• Nicolle Rocina Marlene Benz, DO
• Sergiy Berezhnoy, CO 60911229
• Estee Lee Berg, RN
• Evan Berg, LMT
• Jill Christie Berg, SLP
• Kayla Berg
• Laura Ann Berg, MSW
• Lauren Alessandra Berg, RN
• Michael P Berg, MD

• Physical Therapy Assistant in Spokane, WA
• Providers in Spokane, WA by specialty
• Physical Therapy Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; 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.