Kent M Berney, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

1266-057 Issued in WI

Practice address

1300 South Drive
Winnebago, WI 54985-0009

Phone

(920) 235-4910

Fax

(920) 236-2931

NPI assigned

Apr 13, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Winnebago Mental Health Institute

  • Psychiatric Hospital
  • Winnebago, WI
  • NPI 1164516506
  NPD (past)

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203120000000",
    "number": "1962626317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 UNIVERSITY AVE",
            "address_2": "SUITE # 300",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537034915",
            "telephone_number": "608-255-3340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 SOUTH DRIVE",
            "city": "WINNEBAGO",
            "state": "WI",
            "postal_code": "549850009",
            "telephone_number": "920-235-4910",
            "fax_number": "920-236-2931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNEY",
        "first_name": "KENT",
        "middle_name": "M",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-13",
        "last_updated": "2008-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "1266-057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "1266-057",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Felipe M Ambas, M.D.
• Chong T Arong, M.D.
• Maria L Baldomero, M.D.
• Marshall John Bales, M.D.
• Paul J Barfknecht, RPH
• Michelle Kaye Burton, APNP
• Charlene A Cain
• Christine N Carriere, APNP
• Jesse Elizabeth Childs, PA-C
• Cognitive Continuum Care

• Psychologist in Winnebago, WI
• Providers in Winnebago, WI by specialty
• Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 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.