Individual provider Active NPI

Jenna Nicole Berg

  • Family Nurse Practitioner
  • Vidor, TX
National Provider Identifier
1881568525
Registry record updated Jan 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1028081 Issued in TX
Practice address
2353 N Main St
Vidor, TX 77662-2610
Phone
(409) 813-1677
Fax
(409) 422-4997
NPI assigned
Oct 4, 2025
Last updated
Jan 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1028081 TX
Family Nurse Practitioner 363LF0000X 1028081 TX Primary

Addresses

Primary practice location

2353 N Main St
Vidor, TX 77662-2610

Mailing address

3406 College St Ste 200
Beaumont, TX 77701-4612
Phone (409) 813-1677

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20260108004022 TX Practitioner - Nurse Practitioner 7911483987 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Diagnostic Group Integrated Healthcare System, PLLCGroup PAC ID 1557506383, 34 clinicians

Practice addresses (Care Compare)

2353 N Main St
Diag GRP Vidor Fam Clin
Vidor, TX 77662-2610
Phone (409) 813-1677

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1028081TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Diagnostic Group Integrated Healthcare System PLLC Nurse Practitioner CurrentSince Dec 16, 2025 Accepting new patients

Locations

3080 College St
Beaumont, TX 77701
Phone (409) 212-5000

3406 College St
Ste 200
Beaumont, TX 77701
Phone (409) 730-2022

288 Country Lane Dr
Lumberton, TX 77657
Phone (409) 227-4413

2200 Highway 365
Nederland, TX 77627
Phone (409) 722-4321

2353 N Main St
Vidor, TX 77662

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1759536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768262400000",
    "number": "1881568525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3406 COLLEGE ST STE 200",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777014612",
            "telephone_number": "409-813-1677",
            "fax_number": "409-736-7167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2353 N MAIN ST",
            "city": "VIDOR",
            "state": "TX",
            "postal_code": "776622610",
            "telephone_number": "409-813-1677",
            "fax_number": "409-422-4997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "JENNA",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-04",
        "last_updated": "2026-01-13",
        "certification_date": "2026-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1028081",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1028081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vidor, TX

Sources for this page

Verify at the official NPI Registry.