CHARLENE BERG BHT, NPI 1700243482 — PHOENIX (AZ)

NPI 1700243482

4+ Years Experience Individual

CHARLENE BERG BHT

01/26/2016
PROVIDER ENUMERATION DATE
01/26/2016
LAST UPDATE DATE
1700243482
NPI NUMBER

About CHARLENE BERG

Sole proprietor? No, Entity Type 1 Provider (Individual) is not a Sole Proprietor.

CHARLENE BERG is a provider established in PHOENIX, AZ. The NPI number of CHARLENE BERG is 1700243482 and was assigned on 01/26/2016. The practitioners primary taxonomy code is: 247200000X .

Mailing address

  • City: MESA
  • State: AZ
  • Postal code: 852014108
  • Phone: 4809693800
  • Address: 924 N COUNTRY CLUB DR

Primary Practice Address

  • Region : PHOENIX, AZ
  • NPI : 1700243482
  • Phone : 6023416540
  • Fax : 6022539015
  • Postalcode : 850031653
  • Address : 609 N 2ND AVE

Provider taxonomy - Technician, Other

  • Taxonomy code: 247200000X

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Taxonomy description: A collective term for persons with specialized training in various narrow fields of expertise whose occupations require training and skills in specific technical processes and procedures; and where further classification is deemed unnecessary by the user.

Contacts:

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  • CHARLENE BERG BHT
  • Address : 609 N 2ND AVE
  • Region : PHOENIX, AZ
  • NPI : 1700243482
  • Phone : 6023416540
  • Fax : 6022539015
  • Postalcode : 850031653

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address609 N 2ND AVE
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NamePHOENIX
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameAZ
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code850031653
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number6023416540
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number6022539015
The fax number associated with the location address of the provider being identified.
NPI1700243482
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1247200000X
A collective term for persons with specialized training in various narrow fields of expertise whose occupations require training and skills in specific technical processes and procedures; and where further classification is deemed unnecessary by the user.
Provider Enumeration Date01/26/2016
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated01/26/2016
The date that a record was last updated or changed.
Entity TypeIndividual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)CHARLENE BERG
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address924 N COUNTRY CLUB DR
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City NameMESA
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameAZ
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code852014108
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number4809693800
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Healthcare Provider Taxonomy Code #1247200000X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Technician, Other
A collective term for persons with specialized training in various narrow fields of expertise whose occupations require training and skills in specific technical processes and procedures; and where further classification is deemed unnecessary by the user.
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Provider Gender CodeF
  • M - male
  • F - female
Is sole proprietorN
  • X - Not Answered
  • Y - Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor
  • N - No, Entity Type 1 Provider (Individual) is not a Sole Proprietor
X

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