NPIMap

Individual provider Active NPI

Gerald C Berg, DC

  • Chiropractor
  • Glendale, AZ
National Provider Identifier
1962576512
Registry record updated Jan 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
7831 AND 4520 PHYSIO Issued in AZ
Practice address
18275 N 59TH Ave
BLDG a Suite 106
Glendale, AZ 85308-1260
Phone
(602) 375-2225
Fax
(602) 942-5662
NPI assigned
Nov 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 7831 AND 4520 PHYSIO AZ Primary

Addresses

Primary practice location

18275 N 59TH Ave
BLDG a Suite 106
Glendale, AZ 85308-1260

Mailing address

18275 N 59TH Ave
BLDG a Suite 106
Glendale, AZ 85308-1260
Phone (602) 375-2225

Other identifiers 3

IdentifierTypeStateIssuer
Z100607OtherAZMEDICARE GROUP
1962576512OtherAZBLUE CROSS BLUE SHIELD
1477686541OtherAZMEDICARE NPI GROUP

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
7831 AND 4520 PHYSIOAZMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Malone Chiropractic PC Chiropractor Past Accepting new patients
Northeast College of Health Sciences Chiropractor Past Accepting new patients
Advanced Care Chiropractic of N.Y., P.C Chiropractor Past Accepting new patients
Zeiler Chiropractic PC Chiropractor Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199232000000",
    "number": "1962576512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18275 N 59TH AVE",
            "address_2": "BLDG A SUITE 106",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853081260",
            "telephone_number": "602-375-2225",
            "fax_number": "602-942-5662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18275 N 59TH AVE",
            "address_2": "BLDG A SUITE 106",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853081260",
            "telephone_number": "602-375-2225",
            "fax_number": "602-942-5662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "GERALD",
        "middle_name": "C",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2008-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "7831 AND 4520 PHYSIO",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "Z100607",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1962576512",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NPI GROUP",
            "identifier": "1477686541",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2008; 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.