Active NPI
Diane L Berge
- Speech-Language Pathologist
- Valparaiso, IN
National Provider Identifier
1902053069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 22004642A
- Practice address
- 2801 Evans Ave
Valparaiso, IN 46383-6940 - Phone
- (219) 462-0786
- Fax
- (219) 548-7543
- NPI assigned
- Aug 20, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 22004642A | IN | Primary |
Addresses
Primary practice location
2801 Evans Ave
Valparaiso, IN 46383-6940
Mailing address
179 Shorewood Dr
Valparaiso, IN 46385-7710
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22004642A | IN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219190400000",
"number": "1902053069",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "179 SHOREWOOD DR",
"city": "VALPARAISO",
"state": "IN",
"postal_code": "463857710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2801 EVANS AVE",
"city": "VALPARAISO",
"state": "IN",
"postal_code": "463836940",
"telephone_number": "219-462-0786",
"fax_number": "219-548-7543"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERGE",
"first_name": "DIANE",
"middle_name": "L",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-20",
"last_updated": "2008-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IN",
"license": "22004642A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Valparaiso, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.