Individual provider Active NPI

Dee Ann Berry, CRNA

  • Certified Registered Nurse Anesthetist
  • Elkhart, IN
National Provider Identifier
1821399197
Registry record updated Nov 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
28182123A Issued in IN
Practice address
500 N Nappanee St
Ste. 11-B
Elkhart, IN 46514-1503
Phone
(574) 522-9922
Fax
(574) 522-9926
NPI assigned
Nov 3, 2010
Last updated
Nov 3, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 28182123A IN Primary

Addresses

Primary practice location

500 N Nappanee St
Ste. 11-B
Elkhart, IN 46514-1503

Mailing address

PO Box 3055
Indianapolis, IN 46206-3055
Phone (317) 567-2180

Other names 1

  • Dee Ann Komarnizki Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110128000766 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 0749469260 Reassigns benefits to 2 organizations
I20120510000577 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 0749469260 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeshore Anesthesia Staffing LLCGroup PAC ID 7416242946, 3 clinicians
La Porte County Anesthesia Associates, LLCGroup PAC ID 4688633241, 26 clinicians

Practice addresses (Care Compare)

2848 Niles Rd
Suite B
Saint Joseph, MI 49085-3352
Phone (269) 428-3300

301 W Homer St
Franciscian Health Michigan City
Michigan City, IN 46360-4358
Phone (219) 877-1033

3500 Franciscan Way
Franciscian Health Michigan City
Michigan City, IN 46360-0021
Phone (219) 877-8511

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28182123AINMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Hospitals at Niles and St Joseph, Inc Current Accepting new patients
Lakeland Hospitals at Niles and St Joseph, Inc CurrentSince Jan 1, 2020 Accepting new patients
La Porte County Anesthesia Associates LLC CurrentSince Dec 15, 2010 Accepting new patients
Lakeland Hospitals at Niles and St Joseph, Inc Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2020 Accepting new patients
Great Lakes Anesthesia, P.C. Nurse Anesthetist, Certified Registered CurrentSince Nov 22, 2010 Accepting new patients
Great Lakes Surgery Center LLC PastSince Sep 12, 2016 Accepting new patients
Great Lakes Anesthesia Indiana and Michigan, PLLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

1004 Parkway Ave
Ste A
Elkhart, IN 46516
Phone (800) 966-7841

500 N Nappanee St
Ste 11B
Elkhart, IN 46514

301 W Homer St
Michigan City, IN 46360
Phone (219) 877-1033

301 W Homer St
#M
Michigan City, IN 46360
Phone (219) 877-1033

3500 Franciscan Way
Michigan City, IN 46360
Phone (219) 852-1524

31 N Saint Joseph Ave
Niles, MI 49120
Phone (269) 428-2417

1234 Napier Ave
Saint Joseph, MI 49085
Phone (269) 982-4941

1234 Napier Ave
#32
Saint Joseph, MI 49085
Phone (269) 428-0118

Interoperability endpoints

  • Direct secure messaging: dberry93739@direct.franciscanalliance.org

Organizations & group practices 8

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 2

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": "1288742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288742400000",
    "number": "1821399197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3055",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462063055",
            "telephone_number": "317-567-2180",
            "fax_number": "317-567-2191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N NAPPANEE ST",
            "address_2": "STE. 11-B",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465141503",
            "telephone_number": "574-522-9922",
            "fax_number": "574-522-9926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "DEE",
        "middle_name": "ANN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-03",
        "last_updated": "2010-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "28182123A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEE",
            "last_name": "KOMARNIZKI",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Elkhart, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.