Individual provider Active NPI

Berdena McGhee Perry, RD, LDN

  • Registered Dietitian
  • Austin, TX
National Provider Identifier
1861897019
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
LD004602 Issued in GA
Practice address
3724 Jefferson St Ste 104
Austin, TX 78731-6204
Phone
(520) 419-1359
NPI assigned
Oct 30, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X L004118 NC
Registered Dietitian 133V00000X LD004602 GA Primary

Addresses

Primary practice location

3724 Jefferson St Ste 104
Austin, TX 78731-6204

Mailing address

2208 Breckenbridge Ave
Augusta, GA 30904-5036

Other practice location 1

1164B Nicklaus Dr
Greenville, NC 27834-8029
Phone (520) 419-1359

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220207000075 GA Practitioner - Registered Dietitian Or Nutrition Professional 7113310640
I20240112001395 TX Practitioner - Registered Dietitian Or Nutrition Professional 7113310640 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nourish, Inc.Group PAC ID 1557724937, 288 clinicians

Practice addresses (Care Compare)

3724 Jefferson St
Suite 104
Austin, TX 78731-6204
Phone (512) 693-7045

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
L004118NCMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Nourish, Inc. Dietitian, Registered CurrentSince Dec 9, 2023 Accepting new patients

Locations

2100 Southbridge Pkwy
Ste 650
Homewood, AL 35209
Phone (205) 533-8902

515 S Flower St
#1015
Los Angeles, CA 90071

260 Peachtree St NW
Ste 2200
Atlanta, GA 30303
Phone (669) 231-6870

525 N Tryon St
Ste 1600
Charlotte, NC 28202
Phone (855) 478-8208

500 Westover Dr
Sanford, NC 27330
Phone (478) 766-4000

1320 Main St
Ste 300
Columbia, SC 29201
Phone (803) 386-1541

3724 Jefferson St
Ste 104
Austin, TX 78731
Phone (512) 399-9039

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1414627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1861897019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2208 BRECKENBRIDGE AVE",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309045036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3724 JEFFERSON ST STE 104",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787316204",
            "telephone_number": "520-419-1359"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1164B Nicklaus Dr",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "278348029",
            "country_code": "US",
            "telephone_number": "520-419-1359",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERRY",
        "first_name": "BERDENA",
        "middle_name": "MCGHEE",
        "credential": "RD, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-30",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L004118",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "GA",
            "license": "LD004602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; 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.