NPIMap

Individual provider Active NPI

Zachary Michael Berry, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Lawton, OK
National Provider Identifier
1811155666
Registry record updated Mar 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
27238 Issued in OK
Practice address
3201 W Gore Blvd
Suite 104
Lawton, OK 73505
Phone
(580) 250-6659
Fax
(580) 250-5249
NPI assigned
May 29, 2008
Last updated
Mar 15, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 27238 OK Primary
Physical Medicine & Rehabilitation Physician 208100000X R1197 KY

Addresses

Primary practice location

3201 W Gore Blvd
Suite 104
Lawton, OK 73505

Mailing address

PO Box 785
Lawton, OK 73502-0785
Phone (580) 357-9984

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090820000364 OK Practitioner - Physical Medicine and Rehabilitation 4183778426 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Louisiana State University School of Medicine in Shreveport, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3201 W Gore Blvd
Suite 300
Lawton, OK 73505-6350
Phone (580) 248-5255

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R1197KYMDPhysical Medicine & Rehabilitation Physician
27238OKMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Comanche County Healthcare Corporation CurrentSince Aug 1, 2009 Accepting new patients
Comanche County Healthcare Corporation Current Accepting new patients
Comanche County Healthcare CurrentSince Aug 1, 2009 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Comanche County Healthcare Past Accepting new patients
Comanche County Hospital Authority Past Accepting new patients

Locations

3201 W Gore Blvd
Ste 104
Lawton, OK 73505
Phone (580) 250-6659

3201 W Gore Blvd
Ste 201
Lawton, OK 73505
Phone (580) 357-2261

3201 W Gore Blvd
Ste 300
Lawton, OK 73505
Phone (580) 248-5255

Interoperability endpoints

  • Direct secure messaging: zachary.berry@mmg.eclinicaldirectplus.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1212019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268611200000",
    "number": "1811155666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 785",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735020785",
            "telephone_number": "580-357-9984",
            "fax_number": "580-357-3277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 W GORE BLVD",
            "address_2": "SUITE 104",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "73505",
            "telephone_number": "580-250-6659",
            "fax_number": "580-250-5249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "ZACHARY",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-29",
        "last_updated": "2010-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "OK",
            "license": "27238",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "KY",
            "license": "R1197",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawton, OK

Sources for this page

Verify at the official NPI Registry.