Individual provider Active NPI

Kristin Berkner, ND

  • Naturopath
  • Queen Creek, AZ
National Provider Identifier
1831428515
Registry record updated Jan 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
NaturopathTaxonomy code 175F00000X
License
09-1135 Issued in AZ
Practice address
21820 S Ellsworth Rd
Suite 101
Queen Creek, AZ 85142-6177
Phone
(480) 296-6173
Fax
(480) 677-8310
NPI assigned
Dec 9, 2009
Last updated
Jan 30, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Naturopath 175F00000X 09-1135 AZ Primary

Addresses

Primary practice location

21820 S Ellsworth Rd
Suite 101
Queen Creek, AZ 85142-6177

Mailing address

18704 E Mary Ann Way
Queen Creek, AZ 85142-9459
Phone (480) 250-1924

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
09-1135AZMDNaturopath

Practice roles

OrganizationSpecialtyStatusNew patients
Queen Creek Naturopathic PLLC CurrentSince Apr 26, 2020 Accepting new patients
Queen Creek Back Care, LLC PastSince Feb 1, 2010 Accepting new patients

Locations

21820 S Ellsworth Rd
Ste 101
Queen Creek, AZ 85142
Phone (480) 296-6173

Interoperability endpoints

  • Direct secure messaging: dr.berkner@org36.direct.charmhealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1260316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359504000000",
    "number": "1831428515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18704 E MARY ANN WAY",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851429459",
            "telephone_number": "480-250-1924",
            "fax_number": "480-677-8310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21820 S ELLSWORTH RD",
            "address_2": "SUITE 101",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851426177",
            "telephone_number": "480-296-6173",
            "fax_number": "480-677-8310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERKNER",
        "first_name": "KRISTIN",
        "credential": "ND",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-09",
        "last_updated": "2013-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "AZ",
            "license": "09-1135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queen Creek, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2013; 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.