Individual provider Active NPI

Dustin Lee Berry, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Virginia Beach, VA
National Provider Identifier
1841448685
Registry record updated Jul 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110006482 Issued in VA
Practice address
1800 Camelot Dr Ste 300
Virginia Beach, VA 23454-2440
Phone
(757) 321-3300
Fax
(757) 321-3330
NPI assigned
Sep 5, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110006482 VA Primary

Addresses

Primary practice location

1800 Camelot Dr Ste 300
Virginia Beach, VA 23454-2440

Mailing address

230 Clearfield Ave Ste 124
VA Beach, VA 23462-1832
Phone (757) 321-3300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110006482VAMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1220572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1841448685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 CLEARFIELD AVE STE 124",
            "city": "VA BEACH",
            "state": "VA",
            "postal_code": "234621832",
            "telephone_number": "757-321-3300",
            "fax_number": "757-321-3330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 CAMELOT DR STE 300",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234542440",
            "telephone_number": "757-321-3300",
            "fax_number": "757-321-3330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "DUSTIN",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-05",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110006482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.