DR. GREGORY M. BERTICS (NPI# 1750313334) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750313334 |
| Entity Type | Individual |
| Full Name | DR. GREGORY M. BERTICS |
| Credential | M.D. |
| Practice Address |
1540 Sunday Dr Raleigh NC 27607-6000 |
| Practice Telephone | 9197823456 |
| Practice Fax Number | 9197877552 |
| Mailing Telephone | 9197823456 |
| Mailing Fax Number | 9197877552 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2011-01-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
31111 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NE | 8915262 | 05 |
| Street Address |
1540 SUNDAY DR |
| City | RALEIGH |
| State | NC |
| Zip Code | 27607-6000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861495905 | Dennis E Bullard | Specialist | 1540 Sunday Dr, Ste 214, Raleigh, NC 27607-6000 | 2005-05-23 |
| 1245758796 | Kristin N Jones | Physician Assistant | 1540 Sunday Dr, Raleigh, NC 27607-6010 | 2017-09-05 |
| 1639618226 | Reham Ghali | Physician Assistant | 1540 Sunday Dr, Raleigh, NC 27607-6010 | 2017-02-16 |
| 1134670193 | Triangle Neurosurgery | Specialist | 1540 Sunday Dr, Raleigh, NC 27607-6010 | 2016-10-14 |
| 1801243795 | Joan Swanson | Physician Assistant | 1540 Sunday Dr, Raleigh, NC 27607-6010 | 2016-05-20 |
| 1881052710 | Meghan Elizabeth Murphy | Nurse Practitioner | 1540 Sunday Dr, Raleigh, NC 27607-6010 | 2016-02-06 |
| 1619332152 | Candace Jackson Moody | Physician Assistant | 1540 Sunday Dr, Raleigh, NC 27607 | 2015-12-29 |
| 1184013435 | Thinh Nguyen | Nurse Practitioner | 1540 Sunday Dr, Raleigh, NC 27607-6010 | 2015-01-09 |
| 1245650068 | Neeja Vivek Desai | Psychiatry & Neurology | 1540 Sunday Dr, Raleigh, NC 27607 | 2014-04-19 |
| 1619395092 | Casey Victoria Farin | Psychiatry & Neurology | 1540 Sunday Dr, Raleigh, NC 27607 | 2014-04-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972093144 | Kyndra Lawson | Behavior Technician | 5121 Kingdom Way, Suite 100, Raleigh, NC 27607 | 2018-05-14 |
| 1578082905 | Margaret Roberts Bova | Dietitian, Registered | 4207 Lake Boone Trail, Suite 210, Raleigh, NC 27607 | 2017-09-18 |
| 1184141897 | Chricat Garrard | Nurse Practitioner | 4207 Lake Boone Trl Ste 200, Raleigh, NC 27607 | 2017-08-23 |
| 1487178620 | John Patrick Morton | Pharmacist | 2411 Landmark Dr, Raleigh, NC 27607 | 2017-07-31 |
| 1023538857 | Heather Margaret Mazzola | Audiologist | 7800 Lake Boone Trail, 100, Raleigh, NC 27607 | 2017-06-22 |
| 1790216984 | North Carolina Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 2411 Landmark Drive, Raleigh, NC 27607 | 2017-03-21 |
| 1558819516 | Corilin Nocito Meggitt | Nurse Practitioner | 4505 Fair Meadows Ln Ste 102, Raleigh, NC 27607 | 2016-09-19 |
| 1942757034 | Stacie Walker | Obstetrics & Gynecology | 4414 Lake Boone Trl Ste 311, Raleigh, NC 27607 | 2016-09-06 |
| 1831644533 | Alisa Smajlagic Howe | Nurse Practitioner | 4210 Lake Boone Trail, Rex Rehab & Nursing Center, Raleigh, NC 27607 | 2016-08-23 |
| 1235598632 | Yoseph Saleh | Dentist | 107 Minden Ln, Raleigh, NC 27607 | 2016-02-15 |
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| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356538698 | Susan Pate | Psychiatry & Neurology | 605 Marlowe Rd, Raleigh, NC 27609-7021 | 2007-10-01 |
| 1801842794 | David A Konanc | Psychiatry & Neurology | Raleigh Neurology Associates, Pa, 1540 Sunday Dr., Raleigh, NC 27607-5163 | 2006-05-25 |
| 1659342806 | Philip A Davenport | Psychiatry & Neurology | 3480 Wake Forest Rd, Suite 502, Raleigh, NC 27609-7376 | 2006-01-27 |
| 1659767911 | Wayneho Kam | Psychiatry & Neurology | 3400 Wake Forest Rd, Raleigh, NC 27609-7317 | 2015-04-13 |
| 1245650068 | Neeja Vivek Desai | Psychiatry & Neurology | 1540 Sunday Dr, Raleigh, NC 27607 | 2014-04-19 |
| 1619395092 | Casey Victoria Farin | Psychiatry & Neurology | 1540 Sunday Dr, Raleigh, NC 27607 | 2014-04-02 |
| 1205272663 | Raleigh Neurology Associates, Pa | Psychiatry & Neurology | 3701 Wake Forest Rd, Raleigh, NC 27609-6832 | 2013-05-13 |
| 1992048680 | Raleigh Neurology Associates, P.a. | Psychiatry & Neurology | 1520 Sunday Dr, Raleigh, NC 27607-5253 | 2013-04-01 |
| 1265728489 | Chandni Pankaj Kalaria | Psychiatry & Neurology | 1540 Sunday Dr, Raleigh, NC 27607 | 2011-06-27 |
| 1205125101 | Mariam Wasim | Psychiatry & Neurology | 3480 Wake Forest Rd Ste 310, Raleigh, NC 27609 | 2011-03-31 |
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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.