Individual provider Active NPI

Michael Kawika Berry, CPRSS, CHW

  • Peer Specialist
  • Reno, NV
National Provider Identifier
1780431981
Registry record updated Nov 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
5096 Issued in NV
Practice address
1920 E 4TH St
Reno, NV 89512-3705
Phone
(775) 786-4673
NPI assigned
May 4, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Peer SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 175T00000X
Peer Specialist 175T00000X 5096 NV Primary

Addresses

Primary practice location

1920 E 4TH St
Reno, NV 89512-3705

Mailing address

580 W 5TH St
Reno, NV 89503-4407
Phone (775) 221-6165

Other practice location 1

580 W 5th St
Reno, NV 89503-4407
Phone (775) 786-4673 ext. 7090

Other practice location 2

1905 E 4th St
Reno, NV 89512-3789
Phone (775) 786-4673

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

LicenseStateTypeSpecialty
5096NVMDPeer Specialist

NPI Registry JSON

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

{
    "created_epoch": "1714780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762992000000",
    "number": "1780431981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 W 5TH ST",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895034407",
            "telephone_number": "775-221-6165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 E 4TH ST",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895123705",
            "telephone_number": "775-786-4673"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "580 W 5th St",
            "address_purpose": "LOCATION",
            "city": "Reno",
            "state": "NV",
            "postal_code": "895034407",
            "country_code": "US",
            "telephone_number": "775-786-4673 x7090",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1905 E 4th St",
            "address_purpose": "LOCATION",
            "city": "Reno",
            "state": "NV",
            "postal_code": "895123789",
            "country_code": "US",
            "telephone_number": "775-786-4673",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERRY",
        "first_name": "MICHAEL",
        "middle_name": "KAWIKA",
        "credential": "CPRSS, CHW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-04",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NV",
            "license": "5096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2025; 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.