Individual provider Active NPI

Justin Berg, D.C.

  • Chiropractor
  • Greenville, SC
National Provider Identifier
1871994160
Registry record updated Sep 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC3954DC Issued in SC
Practice address
2541 N Pleasantburg Dr
Suite R
Greenville, SC 29609-2728
Phone
(864) 354-5467
NPI assigned
Sep 6, 2014
Last updated
Sep 6, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC3954DC SC Primary

Addresses

Primary practice location

2541 N Pleasantburg Dr
Suite R
Greenville, SC 29609-2728

Mailing address

2541 N Pleasantburg Dr
Suite R
Greenville, SC 29609-2728
Phone (864) 354-5467

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141114001166 SC Practitioner - Chiropractic 6406078062 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Sherman College of Straight Chiropractic, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2541 N Pleasantburg Dr
Suite R
Greenville, SC 29609-2728
Phone (864) 501-3600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC3954DCSCMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Berg Chiropractic Centers Chiropractor CurrentSince Sep 15, 2014 Accepting new patients

Locations

1615 Wade Hampton Blvd
Ste D
Greenville, SC 29609
Phone (864) 501-3600

2541 N Pleasantburg Dr
Ste R
Greenville, SC 29609
Phone (864) 370-0911

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, 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": "1409961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409961600000",
    "number": "1871994160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2541 N PLEASANTBURG DR",
            "address_2": "SUITE R",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296092728",
            "telephone_number": "864-354-5467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2541 N PLEASANTBURG DR",
            "address_2": "SUITE R",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296092728",
            "telephone_number": "864-354-5467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-06",
        "last_updated": "2014-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "DC3954DC",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2014; 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.