Individual provider Active NPI

Nicole Marie Berry, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Elizabethtown, KY
National Provider Identifier
1952771263
Registry record updated Jul 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
4060984 Issued in KY
Practice address
201 Peterson Dr
Elizabethtown, KY 42701-9370
Phone
(270) 765-5900
NPI assigned
Sep 29, 2015
Last updated
Jul 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4060984 KY Primary
Dental Hygienist 124Q00000X 3995 KY

Addresses

Primary practice location

201 Peterson Dr
Elizabethtown, KY 42701-9370

Mailing address

600 Edgewater Dr
Elizabethtown, KY 42701-2122
Phone (270) 766-7602

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3995KYMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Stepworks Recovery Centers LLC PastSince Jul 8, 2026 Accepting new patients
Stepworks Recovery Centers LLC PastSince Jul 8, 2026 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1443484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783468800000",
    "number": "1952771263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 EDGEWATER DR",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012122",
            "telephone_number": "270-766-7602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 PETERSON DR",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427019370",
            "telephone_number": "270-765-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-29",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "4060984",
            "primary": true
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "KY",
            "license": "3995",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, KY

Sources for this page

Verify at the official NPI Registry.