Wayne Berg, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

6353658-4405 Issued in UT

Practice address

2965 W 3500 S
West Valley City, UT 84119-3602

Phone

(801) 965-3600

NPI assigned

Jul 7, 2017

Last updated

Jun 29, 2023By the provider in NPPES

Sex

Male

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

Enrolled in UT, ID2 enrollments

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.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bear Lake County Memorial HospitalGroup PAC ID 5395799860, 31 clinicians

Caribou Medical Center, IncGroup PAC ID 7618365701, 35 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Caribou Medical Center Hospital, Soda Springs, ID, CCN 131309
• Franklin County Medical Center Hospital, Preston, ID, CCN 131322

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: wayne.berg.1@17373.direct.athenahealth.com

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.

• Bear Lake County Memorial Hospital

  dba Bear Lake Internal Medicine

  • Internal Medicine Physician
  • Montpelier, ID
  • NPI 1174741441

  Clinic/Center

  Medicare reassignment Care Compare group NPD
• Caribou Medical Center, Inc

  dba Caribou Medical Center

  • Critical Access Hospital
  • Soda Springs, ID
  • NPI 1942970272

  Clinic/Center

  Medicare reassignment Care Compare group NPD
• Granger Medical Clinic PC

  • Multi-Specialty Clinic/Center
  • West Valley City, UT
  • NPI 1184657041
  Medicare reassignment NPD
• Granger Medical Specialists LLC

  • Clinic/Center
  • West Valley City, UT
  • NPI 1376159368
  Medicare reassignment NPD
• Bear Lake County Memorial Hospital

  dba BLMH Bear Lake Clinic

  • Multi-Specialty Clinic/Center
  • Garden City, UT
  • NPI 1538916333
  NPD
• Granger Medical Clinic PC

  dba Granger Medical West Jordan

  • Multi-Specialty Clinic/Center
  • West Jordan, UT
  • NPI 1104857549
  NPD
• Granger Medical Specialists, LLC

  • Multi-Specialty Clinic/Center
  • Salt Lake City, UT
  • NPI 1497441539
  NPD
• Bear Lake County Memorial Hospital

  • Orthopaedic Surgery Physician
  • Montpelier, ID
  • NPI 1376871749
  NPD
• Caribou Medical Center, Inc

  dba Lakeview Medical Clinic

  • Rural Health Clinic/Center
  • Soda Springs, ID
  • NPI 1548930878
  NPD
• Franklin County Medical Center

  dba FCMC Medical Clinic

  • Rural Health Clinic/Center
  • Preston, ID
  • NPI 1144663543
  NPD (past)
• Franklin County Medical Center

  dba FCMC Specialty Clinic

  • Critical Access Hospital
  • Preston, ID
  • NPI 1548355811

  Clinic/Center

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Caribou Medical Center, Inc

  dba Caribou Medical Center

  • Critical Access Hospital
  • Soda Springs, ID
  • NPI 1942970272
  Care Compare affiliation
• Franklin County Medical Center

  dba FCMC Specialty Clinic

  • Critical Access Hospital
  • Preston, ID
  • NPI 1548355811
  Care Compare affiliation

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

{
    "created_epoch": "1499385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1851813299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7181 S CAMPUS VIEW DR STE 200",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840844312",
            "telephone_number": "801-965-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2965 W 3500 S",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841193602",
            "telephone_number": "801-965-3600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1873 N 775 W",
            "address_purpose": "LOCATION",
            "city": "West Bountiful",
            "state": "UT",
            "postal_code": "840871160",
            "country_code": "US",
            "telephone_number": "801-414-5109",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1060 E 100 S Ste 110",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841021591",
            "country_code": "US",
            "telephone_number": "801-531-9453",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERG",
        "first_name": "WAYNE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-07",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "6353658-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in West Valley City, UT
• Providers in West Valley City, UT by specialty
• Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; 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.
• 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.