Individual provider Active NPI

Kellie Elizabeth Berry, APRN- CNP

  • Adult Health Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1790438604
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APRN.CNP.0029672 Issued in OH
Practice address
460 W 10TH Ave FL 5
Columbus, OH 43210-1240
Phone
(614) 293-3196
Fax
(614) 293-4812
NPI assigned
Jan 31, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 30889 SC
Primary Care Nurse Practitioner 363LP2300X APRN.CNP.0029672 OH
Gerontology Nurse Practitioner 363LG0600X APRN.CNP.0029672 OH
Adult Health Nurse Practitioner 363LA2200X APRN.CNP.0029672 OH Primary

Addresses

Primary practice location

460 W 10TH Ave FL 5
Columbus, OH 43210-1240

Mailing address

700 Ackerman Rd Ste 2120
Columbus, OH 43202-1559
Phone (614) 293-3196

Other identifiers 1

IdentifierTypeStateIssuer
0477126MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20251001002771 SC Practitioner - Nurse Practitioner 1759775869 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Curana Health of South Carolina PCGroup PAC ID 1951672617, 226 clinicians
CH Specialty Services SC LLCGroup PAC ID 6608182993, 222 clinicians

Practice addresses (Care Compare)

2375 Baker Hospital Blvd
North Charleston, SC 29405-8233
Phone (737) 226-6700

6650 Rivers Ave
North Charleston, SC 29406-4809
Phone (337) 991-9276

Hospital & facility affiliations

  • Amedisys Home Health of Charleston East Home health agency, Charleston, SC, CCN 427027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30889SCMDInternal Medicine Physician
APRN.CNP.0029672OHMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CH Specialty Services SC LLC CurrentSince Sep 16, 2025 Accepting new patients
Curana Health of South Carolina PC CurrentSince Sep 16, 2025 Accepting new patients

Locations

4000 Faber Place Dr
Ste 300
North Charleston, SC 29405
Phone (704) 956-3062

6650 Rivers Ave
North Charleston, SC 29406
Phone (843) 260-5361

2375 Baker Hospital Blvd
North Charleston, SC 29405
Phone (843) 744-2750

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1643587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1790438604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD STE 2120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559",
            "telephone_number": "614-293-3196",
            "fax_number": "614-293-4812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 W 10TH AVE FL 5",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101240",
            "telephone_number": "614-293-3196",
            "fax_number": "614-293-4812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "KELLIE",
        "middle_name": "ELIZABETH",
        "credential": "APRN- CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-31",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "SC",
            "license": "30889",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OH",
            "license": "APRN.CNP.0029672",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OH",
            "license": "APRN.CNP.0029672",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "APRN.CNP.0029672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0477126",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.