MOLLY REBECCA BERG (NPI# 1902878523) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1902878523 |
Entity Type | Individual |
Full Name | MOLLY REBECCA BERG |
Credential | CNP |
Practice Address |
1417 S Cliff Ave Ste 100 Sioux Falls SD 57105-1063 |
Mailing Address |
Po Box 86370 Sioux Falls SD 57118-6370 |
Practice Telephone | 6053228937 |
Practice Fax Number | 6053228938 |
Mailing Telephone | 6053227510 |
Mailing Fax Number | 6053226475 |
Enumeration Date | 2006-02-07 |
Last Update Date | 2018-10-10 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LP1700X |
Nurse Practitioner Specialization: Perinatal |
CP000444 | SD | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
SD | MIDLANDS CHOICE | 248008 | 01 |
MN | PRIMEWEST | 924114229808 | 01 |
MN | 122586300 | 05 | |
SD | ARAZ/ AMERICA'S PPO | 2387950 | 01 |
IA | 0503706 | 05 | |
NE | 10025040700 | 05 | |
SD | PREFERRED ONE | 283761045257 | 01 |
SD | 6828250 | 05 | |
SD | DAKOTACARE | 9243925 | 01 |
SD | WPS TRICARE | 57105AD04 | 01 |
SD | DEPT OF LABOR | 370624200 | 01 |
SD | BLUE CROSS | 4994372 | 01 |
MN | BLUE CROSS | 263P6DA | 01 |
MN | CC SYSTEMS/ BLUE PLUS | 263P6DA | 01 |
SD | MEDICA | 0705288 | 01 |
SD | 6828252 | 05 | |
SD | HEALTHPARTNERS | HP55698 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1285081323 | Molly Ann Berg | Nurse Practitioner | 801 Broadway N, Fargo, ND 58102-3641 | 2016-05-18 |
Street Address |
1417 S CLIFF AVE STE 100 |
City | SIOUX FALLS |
State | SD |
Zip Code | 57105-1063 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619972783 | Christopher Michael Hurley | Internal Medicine | 1417 S Cliff Ave, Suite 300, Sioux Falls, SD 57105-1022 | 2005-06-16 |
1538533427 | Christina Jean Pekoske | Physician Assistant | 1417 S Cliff Ave, Suite 101, Sioux Falls, SD 57105-1022 | 2015-11-16 |
1386045862 | Tabitha Marie Ammann | Nurse Practitioner | 1417 S Cliff Ave, Suite #101a, Sioux Falls, SD 57105-1022 | 2014-09-15 |
1144635988 | Katelin Marie Soodsma | Nurse Practitioner | 1417 S Cliff Ave, Suite 101a, Sioux Falls, SD 57105-1063 | 2014-06-30 |
1568700631 | Kali Swift | Genetic Counselor, MS | 1417 S Cliff Ave, Suite 100, Sioux Falls, SD 57105-1022 | 2013-01-24 |
1376716647 | Annette Lee Siewert | Obstetrics & Gynecology | 1417 S Cliff Ave, Ste. 401, Sioux Falls, SD 57105-1022 | 2008-04-08 |
1770753246 | Avera Mckennan | Clinic/Center | 1417 S Cliff Ave, Suite 302, Sioux Falls, SD 57105-1062 | 2008-03-11 |
1619176328 | Amber Ray Saloum | Obstetrics & Gynecology | 1417 S Cliff Ave, Suite 401, Sioux Falls, SD 57105-1064 | 2007-07-12 |
1760691794 | Cristina Alison Hill Jensen | Internal Medicine | 1417 S Cliff Ave, Ste 300, Sioux Falls, SD 57105-1062 | 2007-05-22 |
1588871859 | Jason Lewis Picconi | Medical Genetics | 1417 S Cliff Ave, Plaza 1, Suite 100, Sioux Falls, SD 57105-1022 | 2007-05-17 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871117549 | Ashlesha Ravindra Bagwe | Student in an Organized Health Care Education/Training Program | Pediatrics Residency Program, 1305 W 18th St, Rt 6364, Sioux Falls, SD 57105 | 2020-05-29 |
1306494489 | Kelsey Elaine Kruse | Counselor | 3101 West 41st, Sioux Falls, SD 57105 | 2019-08-30 |
1902388341 | Sarah Tacke | Nurse Practitioner | 1301 West 18th Street, Sioux Falls, SD 57105 | 2018-09-02 |
1235624727 | Mahum Shahid | Student in an Organized Health Care Education/Training Program | 1400 W. 22nd St, Sioux Falls, SD 57105 | 2018-06-27 |
1942790126 | Smitha Narayana Gowda | Student in an Organized Health Care Education/Training Program | 1400 22nd Street, Sioux Falls, SD 57105 | 2018-05-14 |
1326538554 | Mali Elizabeth Teller | Speech-Language Pathologist | 2501 W. 26th Street, Sioux Falls, SD 57105 | 2018-05-14 |
1871081505 | Abdelmohaymin Abdalla Abufatima Abdalla | Student in an Organized Health Care Education/Training Program | Usd-ssom-internal Medicine Residency, 1400 22nd Street, Sioux Falls, SD 57105 | 2018-04-27 |
1710474697 | Moataz Ellithi | Student in an Organized Health Care Education/Training Program | 1400 W. 22nd St., Sioux Falls, SD 57105 | 2018-04-17 |
1366948663 | Holly Ahlers | Registered Nurse | 2000 S. Summit Ave, Sioux Falls, Sd 57105, Sioux Falls, SD 57105 | 2018-04-04 |
1558864124 | Darcy Lee Jensen | Counselor | 822 East 41st. Street, Suite 235, Souix Falls, SD 57105 | 2018-03-09 |
Find all providers in zip 57105 |
Taxonomy Code | 363LP1700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Perinatal |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1093787616 | Shannon Lynn Backstrom | Nurse Practitioner | 1417 S. Cliff Ave., Ste. 100, Sioux Falls, SD 57105-1063 | 2006-02-07 |
City | SIOUX FALLS |
Zip Code | 57105 |
Please comment or provide details below to improve the information on MOLLY REBECCA BERG.
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.