John Christopher Berry, MD

Individual provider Active NPI Pediatrics Physician · Fort Rucker, AL

NPI 1982854790 · NPPES record last updated Aug 3, 2023

Key facts

NPI
1982854790
Entity type
Individual (NPI type 1)
Primary specialty
Pediatrics Physician 208000000X
License
25665 (NE)
Practice address
301 E. Andrews Avenue
Fort Rucker, AL 36362
Phone
(334) 255-7120
NPI assigned
Sep 29, 2008
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20141110001386 AL Order and Referring Only - Pediatric Medicine
Practitioner - Pediatric Medicine
2769604693

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25665NEMDPediatrics Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25665 NE Yes

Addresses

Primary practice location

301 E. Andrews Avenue
Fort Rucker, AL 36362

Mailing address

4301 Jones Bridge Rd
Bethesda, MD 20814-4799
Phone (202) 460-1021

Other practice location 1

4301 Jones Bridge Rd
Bethesda, MD 20814-4799
Phone (202) 460-1021

Other providers in Fort Rucker, AL

All providers in Fort Rucker, AL · Pediatrics Physician in Alabama

Sources for this page

Verify at the official NPI Registry.