Allen Lewis Berry III, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD00018876 Issued in WA

Practice address

808 N 5TH Ave
Sequim, WA 98382-3045

Phone

(360) 683-5900

Fax

(360) 582-4800

NPI assigned

May 19, 2006

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Sequim Physician Clinic

  • Primary Care Clinic/Center
  • Sequim, WA
  • NPI 1740238054
  NPD (past) Authorized official
• Gibson Community Hospital Association

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288656000000",
    "number": "1972557700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 N 5TH AVE",
            "city": "SEQUIM",
            "state": "WA",
            "postal_code": "983823045",
            "telephone_number": "360-683-5900",
            "fax_number": "360-582-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 N 5TH AVE",
            "city": "SEQUIM",
            "state": "WA",
            "postal_code": "983823045",
            "telephone_number": "360-683-5900",
            "fax_number": "360-582-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "ALLEN",
        "middle_name": "LEWIS",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2010-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00018876",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I DR. BERRY",
            "identifier": "17445",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1816602",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE DR. BERRY",
            "identifier": "BE7778",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James A Benson, RPH
• Diane Joy Bereiter, SLPA
• Bradi Bergesen
• Noelle Denae Bergmann, SUDPT
• Annette Berlin, MHC-ASSOCIATE
• Allison Diane Berry, MD
• Alla V Bess
• Lorena Bess
• Cherry Bibler, PT
• Brenda J Bigger, LMP

• All providers in Sequim, WA
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2010; 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.