Organization Active NPI

Berry Chiropractic PA

  • Chiropractor
  • Waconia, MN
National Provider Identifier
1902083967
Registry record updated Jan 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4368 Issued in MN
Legal business name
BERRY CHIROPRACTIC PA
Practice address
137 W 1St St
Waconia, MN 55387-1190
Phone
(952) 442-4555
Fax
(952) 442-4555
NPI assigned
Jan 22, 2008
Last updated
Jan 22, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2008

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

Authorized official

Name
Dr. Cale Allan Berry, D.C.NPI 1689789349
Title
President
Phone
(952) 442-4555

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4368 MN Primary

Addresses

Primary practice location

137 W 1St St
Waconia, MN 55387-1190

Mailing address

137 W 1St St
Waconia, MN 55387-1190
Phone (952) 442-4555

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080129000306 MN Part B Supplier - Clinic/Group Practice 1951483072 Receives reassigned benefits from 1 practitioner
Practice locations: Waconia, MN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1200960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200960000000",
    "number": "1902083967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 W 1ST ST",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871190",
            "telephone_number": "952-442-4555",
            "fax_number": "952-442-4555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 W 1ST ST",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871190",
            "telephone_number": "952-442-4555",
            "fax_number": "952-442-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERRY CHIROPRACTIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-22",
        "last_updated": "2008-01-22",
        "status": "A",
        "authorized_official_last_name": "BERRY",
        "authorized_official_first_name": "CALE",
        "authorized_official_middle_name": "ALLAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "952-442-4555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waconia, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.