Tayler Nicole Berry

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

4238 NE 1St St
Pryor, OK 74361-9614

Phone

(918) 825-1930

NPI assigned

Jun 10, 2024

Sex

Female

Sole proprietor

Yes

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.

• Second Chance Recovery Center, Inc.

  • Substance Abuse Rehabilitation Facility
  • Pryor, OK
  • NPI 1790301893
  NPD

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 10, 2024.

{
    "created_epoch": "1717977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1972345155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4238 NE 1ST ST",
            "city": "PRYOR",
            "state": "OK",
            "postal_code": "743619614",
            "telephone_number": "918-825-1930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4238 NE 1ST ST",
            "city": "PRYOR",
            "state": "OK",
            "postal_code": "743619614",
            "telephone_number": "918-825-1930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "TAYLER",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-10",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Beebe
• Megan M Beeney
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• Brandy Bentz
• Tracy Alan Best
• Abagail Black
• Harry Black
• Alesha Gail Blake
• Blessed Bites Inc

• All providers in Pryor, OK
• Peer Specialist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; 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.