Individual provider Active NPI

Myra Lea Berry, APRN

  • Women's Health Nurse Practitioner
  • Eufaula, OK
National Provider Identifier
1942504378
Registry record updated Jul 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
71865 Issued in OK
Practice address
800 W Forrest Ave
Eufaula, OK 74432-3249
Phone
(918) 689-2547
Fax
(918) 689-1127
NPI assigned
Dec 28, 2010
Last updated
Jul 11, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 71865 OK Primary

Addresses

Primary practice location

800 W Forrest Ave
Eufaula, OK 74432-3249

Mailing address

800 W Forrest Ave
Eufaula, OK 74432-3249
Phone (918) 689-2547

Other identifiers 1

IdentifierTypeStateIssuer
200335460AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130927000623 OK Practitioner - Nurse Practitioner 7012141344 Reassigns benefits to 1 organization
I20210415000070 TX Practitioner - Nurse Practitioner 7012141344 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Creek Nation Hospital and ClinicsGroup PAC ID 5698786226, 364 clinicians

Practice addresses (Care Compare)

10109 E 79TH St
Tulsa, OK 74133-4564
Phone (918) 756-4333

500 Eunice Burns Rd
Eufaula, OK 74432-4052
Phone (918) 689-2547

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.12 of 100Reported as group
Quality
83.76
Promoting interoperability
100
Improvement activities
40
Cost
56.64

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Creek Nation Hospital & Clinics CurrentSince Jul 15, 2013 Accepting new patients
Creek Nation Hospital & Clinics Current Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Jan 1, 2021 Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Jul 15, 2013 Accepting new patients
Creek Nation Hospital & Clinics Past Accepting new patients

Locations

500 Eunice Burns Rd
Eufaula, OK 74432
Phone (918) 618-2168

800 W Forrest Ave
Eufaula, OK 74432
Phone (918) 618-2460

1800 E Coplin St
Okemah, OK 74859
Phone (918) 623-1424

309 N 14th St
Okemah, OK 74859
Phone (918) 623-1424

1401 Morris Dr
Okmulgee, OK 74447
Phone (918) 456-0641

900 E Airport Rd
Okmulgee, OK 74447
Phone 91875643334448

1125 E Cleveland Ave
Sapulpa, OK 74066
Phone (918) 224-9310

10109 E 79th St
Tulsa, OK 74133
Phone (888) 552-6760

Dept 1467
Tulsa, OK 74182

Interoperability endpoints

  • Direct secure messaging: mberry17971@muscogeecreeknation.direct-ci.com

Organizations & group practices 5

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 2

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": "1293494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373500800000",
    "number": "1942504378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 W FORREST AVE",
            "city": "EUFAULA",
            "state": "OK",
            "postal_code": "744323249",
            "telephone_number": "918-689-2547",
            "fax_number": "918-689-1127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W FORREST AVE",
            "city": "EUFAULA",
            "state": "OK",
            "postal_code": "744323249",
            "telephone_number": "918-689-2547",
            "fax_number": "918-689-1127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "MYRA",
        "middle_name": "LEA",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-28",
        "last_updated": "2013-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "OK",
            "license": "71865",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200335460A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eufaula, OK

Sources for this page

Verify at the official NPI Registry.