Individual provider Active NPI

Whitney L Berry, CSFA

  • Surgical Assistant
  • Jackson, GA
National Provider Identifier
1922433200
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical AssistantTaxonomy code 246ZC0007X
License
144655 Issued in GA
Practice address
162 Buck Creek Rd
Jackson, GA 30233-6522
Phone
(210) 793-0904
NPI assigned
Sep 5, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Assistant 246ZC0007X 144655 GA Primary
Surgical Physician Assistant 363AS0400X 14-4655 TX

Addresses

Primary practice location

162 Buck Creek Rd
Jackson, GA 30233-6522

Mailing address

162 Buck Creek Rd
Jackson, GA 30233-6522
Phone (210) 793-0904

Other practice location 1

12103 Dawes Pt
San Antonio, TX 78254-6213
Phone (210) 793-0904

Other practice location 2

8000 Ih 10 West
Suite #600
San Antonio, TX 79230
Phone (210) 793-0904

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

LicenseStateTypeSpecialty
144655GAMDSurgical Assistant
14-4655TXMDSurgical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1378339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1922433200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "162 BUCK CREEK RD",
            "city": "JACKSON",
            "state": "GA",
            "postal_code": "302336522",
            "telephone_number": "210-793-0904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 BUCK CREEK RD",
            "city": "JACKSON",
            "state": "GA",
            "postal_code": "302336522",
            "telephone_number": "210-793-0904"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12103 Dawes Pt",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782546213",
            "country_code": "US",
            "telephone_number": "210-793-0904",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8000 IH 10 WEST",
            "address_2": "SUITE #600",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "79230",
            "country_code": "US",
            "telephone_number": "210-793-0904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERRY",
        "first_name": "WHITNEY",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "CSFA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-05",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "GA",
            "license": "144655",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "14-4655",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.