Deborah D Berry, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

5601001869 Issued in MI

Practice address

66707 Gratiot Ave
Lenox, MI 48050-2019

Phone

(586) 727-5840

Fax

(586) 727-5897

NPI assigned

Jan 11, 2012

Sex

Female

Sole proprietor

No

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1326240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326240000000",
    "number": "1811267529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 187",
            "city": "RICHMOND",
            "state": "MI",
            "postal_code": "480620187",
            "telephone_number": "586-727-5840",
            "fax_number": "586-727-5897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66707 GRATIOT AVE",
            "city": "LENOX",
            "state": "MI",
            "postal_code": "480502019",
            "telephone_number": "586-727-5840",
            "fax_number": "586-727-5897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "DEBORAH",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-11",
        "last_updated": "2012-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601001869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Physician Assistant in Lenox, MI
• Providers in Lenox, MI by specialty
• Medical Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.