Active NPI
Susan E. Berg, A.R.N.P.
- Clinical Nurse Specialist
- Cave Junction, OR
National Provider Identifier
1972506202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Nurse Specialist
- License
- AP30006914
- Practice address
- 25647 Redwood Hwy
Cave Junction, OR 97523-9332 - Phone
- (541) 592-4111
- Fax
- (541) 592-3916
- NPI assigned
- May 31, 2005
- Last updated
- Jan 21, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Nurse Specialist | 364S00000X | AP30006914 | WA | Primary |
Addresses
Primary practice location
25647 Redwood Hwy
Cave Junction, OR 97523-9332
Mailing address
1701 NW Hawthorne Ave
Suite 201
Grants Pass, OR 97526-1257
Phone (541) 471-3455
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
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP30006914 | WA | MD | Clinical Nurse Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grant County Health District | Past | Accepting new patients | |
| County of Grant | Past | 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.
-
- Public Health or Welfare Agency
- Moses Lake, WA
- NPI 1295915247
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390262400000",
"number": "1972506202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1701 NW HAWTHORNE AVE",
"address_2": "SUITE 201",
"city": "GRANTS PASS",
"state": "OR",
"postal_code": "975261257",
"telephone_number": "541-471-3455",
"fax_number": "541-471-1439"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25647 REDWOOD HWY",
"city": "CAVE JUNCTION",
"state": "OR",
"postal_code": "975239332",
"telephone_number": "541-592-4111",
"fax_number": "541-592-3916"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERG",
"first_name": "SUSAN",
"middle_name": "E.",
"credential": "A.R.N.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-05-31",
"last_updated": "2014-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "364S00000X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist",
"state": "WA",
"license": "AP30006914",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cave Junction, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.