Marcella Berry, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

835094 Issued in NV

Practice address

2580 N Rancho Dr Ste 103
Las Vegas, NV 89130-3361

Phone

(725) 780-7880

Fax

(725) 780-7890

NPI assigned

Sep 6, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Las Vegas Functional Health and Wellness

  • Nurse Practitioner
  • Las Vegas, NV
  • NPI 1417743980
  NPD Authorized official

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

{
    "created_epoch": "1725580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1811722903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2265 MORESCA AVE",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890526548",
            "telephone_number": "818-795-7597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2580 N RANCHO DR STE 103",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891303361",
            "telephone_number": "725-780-7880",
            "fax_number": "725-780-7890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "MARCELLA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-06",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "835094",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95031786",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kartaysa Taymee Berry
• Kashiya Berry
• Kathryn Berry
• Kimberly Berry
• Luzcelenia Berry
• Marilyn Cordelia Berry
• Markena K Berry
• Sandra Berry
• Shaquayla Katrice Berry
• Tatyana Berry

• Nurse Practitioner in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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.