Noah Berg, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

3613 Issued in MN

Practice address

4200 Pioneer Dr
Woodbury, MN 55129-9534

Phone

(763) 221-3983

NPI assigned

Jan 16, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1547596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675814400000",
    "number": "1942774559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 MAYWOOD PL",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551175621",
            "telephone_number": "763-221-3983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 PIONEER DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551299534",
            "telephone_number": "763-221-3983"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2090 Woodwinds Dr",
            "address_purpose": "LOCATION",
            "city": "Woodbury",
            "state": "MN",
            "postal_code": "551252522",
            "country_code": "US",
            "telephone_number": "763-221-3983",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERG",
        "first_name": "NOAH",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-01-16",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MN",
            "license": "3613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Ann Bentson
• Cameron Bentz, PT, DPT
• Ashley Berens, OTR/L
• Emily Geneva Beres, MD
• Katie Berg, PHARMD
• Paige Berg, LPCC
• Riley Kenneth Berg
• Laura Ann Berger
• Kathlyn Bergeron, APRN-CNP
• Elaine Grace Berghuis, RBT

• Athletic Trainer in Woodbury, MN
• Providers in Woodbury, MN by specialty
• Athletic Trainer in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2023; 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.