JERRY ANNE BERG (NPI# 1467900951) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467900951 |
| Entity Type | Individual |
| Full Name | JERRY ANNE BERG |
| Credential | NP |
| Practice Address |
2420 Lake Ave Ashtabula OH 44004-4954 |
| Mailing Address |
Po Box 92987 Cleveland OH 44194-3436 |
| Practice Telephone | 4409980322 |
| Practice Fax Number | 4409984525 |
| Mailing Telephone | 4409972262 |
| Mailing Fax Number | 4409976507 |
| Enumeration Date | 2016-09-14 |
| Last Update Date | 2016-09-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
F06161721 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2420 LAKE AVE |
| City | ASHTABULA |
| State | OH |
| Zip Code | 44004-4954 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437154234 | Chandresh S Shah | Specialist | 2420 Lake Ave, Ashtabula, OH 44004-4954 | 2005-06-17 |
| 1467008037 | Cody Blood | Physical Therapist | 2420 Lake Ave, Ashtabula, OH 44004-4954 | 2019-08-10 |
| 1942781919 | Marisa Leigh Huber | Physician Assistant | 2420 Lake Ave, Ashtabula, OH 44004-4954 | 2018-08-27 |
| 1831679042 | Jason Blake Poole | Nurse Practitioner | 2420 Lake Ave, Ashtabula, OH 44004-4954 | 2018-08-16 |
| 1720575723 | Monica Lynn Brown | Specialist/Technologist | 2420 Lake Ave, Ashtabula, OH 44004-4970 | 2018-04-16 |
| 1760991608 | Kathryn H Nelson | Nurse Practitioner | 2420 Lake Ave, Ashtabula, OH 44004-4954 | 2017-09-22 |
| 1528577566 | Elizabeth Gilbert | Physical Therapist | 2420 Lake Ave, Ashtabula, OH 44004-4954 | 2017-09-21 |
| 1972057396 | Kristyn Emily Heagerty | Physician Assistant | 2420 Lake Ave, Ashtabula, OH 44004-4954 | 2016-08-15 |
| 1861861569 | Kathleen Shontz | Nurse Practitioner | 2420 Lake Ave, Ashtabula, OH 44004-4954 | 2015-09-23 |
| 1437552866 | Astabula County Med Ctr | Pharmacy | 2420 Lake Ave, Pharmacy Department, Ashtabula, OH 44004-4954 | 2014-09-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174167050 | Jack Lemmon | Physical Therapist | 2515 Lake Rd E, Ashtabula, OH 44004 | 2019-11-04 |
| 1871060608 | Ahmed Shahata | Obstetrics & Gynecology | Ashtabula County Medical Center/obgyn Dept, 2420 Lake Ave, Ashtabula, OH 44004 | 2018-10-30 |
| 1861999013 | Thomas Webber | Counselor | 2801 C. Court, Ashtabula, OH 44004 | 2018-04-12 |
| 1942702428 | Troy Mills | Hearing Instrument Specialist | 2604 West Prospect Rd, Ashtabula, OH 44004 | 2018-03-01 |
| 1598294886 | Howard Edward Loftus Jr. | Counselor | 4726 Main Ave., Ashtabula, OH 44004 | 2017-06-08 |
| 1861928087 | Hannah Woods | Physical Therapist | 3720 N Ridge Road W, Ashtabula, OH 44004 | 2017-05-08 |
| 1376095422 | Lantern of Saybrook | Assisted Living Facility | 3720 North Ridge Road West, Ashtabula, OH 44004 | 2016-10-25 |
| 1801346366 | Melissa Marie Holland | Licensed Practical Nurse | 2124 W Prospect Rd, Ashtabula, OH 44004 | 2016-10-09 |
| 1184080087 | Kevin M Welsh | Speech-Language Pathologist | 2240 Wade Ave, Ashtabula, OH 44004 | 2016-01-07 |
| 1285021709 | David Hefner | Early Intervention Provider Agency | 600 State Road, Ashtabula, OH 44004 | 2015-04-22 |
| Find all providers in zip 44004 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891302501 | Haley Pritt | Nurse Practitioner | 3937 N Ridge Rd E, Ashtabula, OH 44004-4352 | 2020-09-26 |
| 1659837391 | Milena G Runnion | Nurse Practitioner | 2102 E 39th St, Ashtabula, OH 44004-5911 | 2019-02-19 |
| 1851745012 | T Gallo | Nurse Practitioner | 831 Morton Dr, Ashtabula, OH 44004-3355 | 2016-04-14 |
| 1265877179 | Emily Brown | Nurse Practitioner | 2259 Lake Ave, Ashtabula, OH 44004-3437 | 2013-05-06 |
| 1497028146 | Loreen Faye Ibala | Nurse Practitioner | 2420 Lake Avenue, Ashtabula, OH 44004 | 2012-02-10 |
| 1063470102 | Carol G Kercher | Nurse Practitioner | 1230 Lake Ave, Ashtabula, OH 44004-2932 | 2006-05-01 |
| 1801866595 | Paul E Thompson | Nurse Practitioner | 416 West 27th Street, Ashtabula, OH 44004 | 2006-01-25 |
| 1831679042 | Jason Blake Poole | Nurse Practitioner | 2420 Lake Ave, Ashtabula, OH 44004-4954 | 2018-08-16 |
| 1861861569 | Kathleen Shontz | Nurse Practitioner | 2420 Lake Ave, Ashtabula, OH 44004-4954 | 2015-09-23 |
| 1629461082 | Lisa Bean | Nurse Practitioner | 416 W 27th St, Ashtabula, OH 44004-4975 | 2015-03-10 |
| Find all providers in ASHTABULA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.