RICHARD C BERG JR. (NPI# 1124097977) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124097977 |
| Entity Type | Individual |
| Full Name | RICHARD C BERG JR. |
| Credential | MD |
| Practice Address |
2600 Greenbush St Lafayette IN 47904-2479 |
| Mailing Address |
Po Box 5545 Lafayette IN 47903-5545 |
| Practice Telephone | 7654488000 |
| Practice Fax Number | 7654488027 |
| Mailing Telephone | 7654488000 |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2012-07-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 01056973A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | ANTHEM PROVIDER NUMBER | 000000248484 | 01 |
| IN | MEDICARE UPIN NUMBER | G34750 | 01 |
| IN | PHCS PID NUMBER | 467264 | 01 |
| IN | 200402790 | 05 | |
| IN | CAQH NUMBER | 10923010 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881147502 | Richard Christopher Berg | Emergency Medical Technician, Basic | 12166 Oakview Way, San Diego, CA 92128-5299 | 2016-07-28 |
| 1568669166 | Richard Lewis Berg | Marriage & Family Therapist | 22231 Mulholland Hwy #106, Calabasas, CA 91302-5178 | 2007-06-28 |
| 1811048556 | Richard A Berg | Social Worker | 1109 11th St Sw, Little Falls, MN 56345-1917 | 2007-01-16 |
| 1154401511 | Richard M. Berg | Dentist | 54 Copperfield Cir, Lititz, PA 17543-9483 | 2006-10-17 |
| 1942220082 | Richard C Berg | Pharmacist | Zablocki Department of Veterans Affairs Medical Ctn, 5000 West National Avenue, Milwaukee, WI 53295-0001 | 2006-07-20 |
| 1619963386 | Richard Alan Berg | Radiology | 5882 Birkdale Ln, San Luis Obispo, CA 93401-8906 | 2005-09-27 |
| 1508875907 | Richard Berg | Dentist | 1181 Old Country Rd, Suite 4, Plainview, NY 11803-5018 | 2006-08-05 |
| 1114948817 | Richard A Berg | Clinical Neuropsychologist | 5010 Randall Pkwy, Wilmington, NC 28403-2829 | 2006-07-21 |
| 1770526840 | Richard Berg | Family Medicine | 116 E Front St, Hancock, NY 13783-1242 | 2006-06-14 |
| 1700854148 | Richard Albert Berg | Internal Medicine | 2700 Quarry Lake Drive, Suite 260, Baltimore, MD 21209 | 2006-03-10 |
| Street Address |
2600 GREENBUSH ST |
| City | LAFAYETTE |
| State | IN |
| Zip Code | 47904-2479 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922007996 | Rama Marepally | Internal Medicine | 2600 Greenbush St, Lafayette, IN 47904-2477 | 2005-07-20 |
| 1861039547 | Carly J Yoder | Audiologist | 2600 Greenbush St, Lafayette, IN 47904-2477 | 2019-12-02 |
| 1306488978 | Jana Suzanne Doyle | Registered Nurse | 2600 Greenbush St, Lafayette, IN 47904-2477 | 2019-10-15 |
| 1053968024 | Julie J Debord | Nurse Practitioner | 2600 Greenbush St, Lafayette, IN 47904-2477 | 2019-08-23 |
| 1679120653 | Renee L Weathington | Registered Nurse | 2600 Greenbush St, Lafayette, IN 47904-2477 | 2019-08-23 |
| 1265086565 | Emily L Newlin | Nurse Practitioner | 2600 Greenbush St, Lafayette, IN 47904-2477 | 2019-07-25 |
| 1720555402 | Carrie Ann Anderson | Dietitian, Registered | 2600 Greenbush St, Lafayette, IN 47904-2477 | 2018-10-31 |
| 1306320270 | Britney D Craddock | Nurse Anesthetist, Certified Registered | 2600 Greenbush St, Lafayette, IN 47904-2477 | 2018-09-18 |
| 1790269694 | Kristie J Craddock | Nurse Anesthetist, Certified Registered | 2600 Greenbush St, Lafayette, IN 47904-2477 | 2018-09-18 |
| 1174048797 | Laura A Kilmer | Registered Nurse | 2600 Greenbush St, Lafayette, IN 47904-2477 | 2017-08-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568998615 | Angela Hands | Physical Therapy Assistant | 1260 North 17th Street, Lafayette, IN 47904 | 2017-05-11 |
| 1366894164 | Kathryn Barnett | Behavioral Analyst | 2785 Cason St # 2, Lafayette, IN 47904 | 2016-07-06 |
| 1881972917 | Rest Assured, LLC | Durable Medical Equipment & Medical Supplies | 180 Professional Ct., Lafayette, IN 47904 | 2011-07-22 |
| 1144514233 | Michelle Cristin Singleton | Dietitian, Registered | 508 N 26th St, Lafayette, IN 47904 | 2011-06-06 |
| 1912134438 | Jean D Trammel | Marriage & Family Therapist | 2000 Greenburg St, Bldg B, Suite A, Lafayette, IN 47904 | 2009-06-11 |
| 1902946056 | Terry Richard Baker | Optometrist | 2300 Sagamore Parkway S, Lafayette, IN 47904 | 2007-02-07 |
| 1891862165 | Becki A Bowditch Inc | Social Worker | 2201 Ferry Street, Lafayette, IN 47904 | 2006-11-29 |
| 1326121849 | James Lowell Thomas | Pediatrics | 2300 Ferry St, Lafayette, IN 47904 | 2006-10-21 |
| 1700976719 | Michael Leonard Bagnoli | Dentist | 2020 Union Street, Suite 200, Lafayette, IN 47904 | 2006-10-13 |
| 1255428801 | Lynn Arlen Pestle | Dentist | 2550 Elmwood Avenue, Lafayette, IN 47904 | 2006-10-06 |
| Find all providers in zip 47904 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477922904 | Lafayette Health Ventures, Inc. | Surgery | 121 Audubon Blvd, Lafayette, LA 70503-2606 | 2015-09-15 |
| 1164805719 | Lafayette Health Ventures, Inc. | Surgery | 900 E Saint Mary Blvd, Suite 106, Lafayette, LA 70503-2377 | 2015-07-01 |
| 1043595804 | Surgical Hospital Management System LLC | Surgery | 1000 Pinhook Road, Suite 310, Lafayette, LA 70503-2460 | 2011-10-12 |
| 1275812976 | Flatirons Surgical Specialists, Pllc | Surgery | 2668 N Park Dr, Ste 110, Lafayette, CO 80026-3199 | 2011-08-11 |
| 1194017889 | Ethel Stackhouse Smith | Surgery | 125 Karolwood Dr, Lafayette, LA 70503 | 2011-05-12 |
| 1306137666 | Imtiaz R Khan | Surgery | 5000 Ambassador Caffery Pkwy Ste A, Lafayette, LA 70508-6984 | 2011-04-21 |
| 1386963148 | Leopold Richard, Jr. | Surgery | 406 Oakleaf Dr, Lafayette, LA 70503-3491 | 2010-05-19 |
| 1275760019 | Gary Joseph Arnold | Surgery | 302 Mill Valley Run, Lafayette, LA 70508 | 2009-06-19 |
| 1962681551 | Dennis Joseph Eschete Jr. | Surgery | 1000 W Pinhook Road, Ste 204, Lafayette, LA 70503-2460 | 2007-10-31 |
| 1902999485 | Joseph Peter Lupo | Surgery | 900 E Saint Mary Blvd Ste 104, Lafayette, LA 70503-2378 | 2006-10-02 |
| Find all providers in LAFAYETTE | ||||
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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.