Active NPI
Bonnie L Berg, D.C.
- Chiropractor
- Medford, MA
National Provider Identifier
1992818272
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1118
- Practice address
- 314 Main St
Medford, MA 02155-6160 - Phone
- (781) 396-1070
- Fax
- (781) 396-6607
- NPI assigned
- Aug 17, 2006
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1118 | MA | Primary |
Addresses
Primary practice location
314 Main St
Medford, MA 02155-6160
Mailing address
314 Main St
Medford, MA 02155-6160
Phone (781) 396-1070
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 713630 | Other | MA | TUFTS NUMBER |
| 4130676 | Other | MA | AETNA NUMBER |
| 351243 | Other | MA | HARVARD/PILGRAM NUMBER |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1992818272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "314 MAIN ST",
"city": "MEDFORD",
"state": "MA",
"postal_code": "021556160",
"telephone_number": "781-396-1070",
"fax_number": "781-396-6607"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "314 MAIN ST",
"city": "MEDFORD",
"state": "MA",
"postal_code": "021556160",
"telephone_number": "781-396-1070",
"fax_number": "781-396-6607"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERG",
"first_name": "BONNIE",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-17",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MA",
"license": "1118",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS NUMBER",
"identifier": "713630",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA NUMBER",
"identifier": "4130676",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD/PILGRAM NUMBER",
"identifier": "351243",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Medford, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.