DR. JACK T. BERRY (NPI# 1235327511) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235327511 |
| Entity Type | Individual |
| Full Name | DR. JACK T. BERRY |
| Credential | M.D. |
| Practice Address |
605 N Foster St Mitchell SD 57301-2902 |
| Practice Telephone | 6059955756 |
| Mailing Telephone | 6059955756 |
| Enumeration Date | 2007-10-11 |
| Last Update Date | 2007-10-11 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SOUTH DAKOTA LICENSE # | 0488 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932672755 | Jack Berry | Assistant Behavior Analyst | 11535 Avenue 264, Visalia, CA 93277-9315 | 2019-01-03 |
| Street Address |
605 N FOSTER ST |
| City | MITCHELL |
| State | SD |
| Zip Code | 57301-2902 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568427144 | Stephen Dick | Radiology | 605 N Foster St, Mitchell, SD 57301-2902 | 2006-04-18 |
| 1962927269 | Avera Queen of Peace | Radiology | 605 N Foster St, Mitchell, SD 57301-2902 | 2017-08-08 |
| 1528209434 | Anwarul Haq, Md, PC | Clinic/Center | 605 N Foster St, Mitchell, SD 57301-2902 | 2009-03-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932721388 | Dakota Counseling Institute | Social Worker | 910 W Havens, Mitchell, SD 57301 | 2020-05-08 |
| 1215588512 | Carolyn Marie Klinkhammer | Registered Nurse | 525 North Foster - Avera Queen of Peace Hospital, Mitchell, SD 57301 | 2019-09-27 |
| 1720596893 | Brian Bannwarth | Pharmacist | 25147 Campground Road, Mitchell, SD 57301 | 2018-01-11 |
| 1336664135 | Haley Long | Speech-Language Pathologist | 200 East Havens, Mitchell, SD 57301 | 2017-08-14 |
| 1770004996 | Edgewood Mitchell LLC | Assisted Living Facility | 501 East Spruce Street, Mitchell, SD 57301 | 2017-06-28 |
| 1467831685 | Amanda Louise Johnson | Physical Therapist | 910 S Edgerton, Mitchell, SD 57301 | 2015-05-20 |
| 1922432830 | Melissa Jill Maier | Dentist | 240 E 23 Ave, Mitchell, SD 57301 | 2013-08-27 |
| 1356626972 | Lewis Family Drug, LLC | Pharmacy | 1507 N Main St, Mitchell, SD 57301 | 2011-10-14 |
| 1184945958 | Kimberly L Lienemann | Counselor | 403 N Lawler St, Mitchell, SD 57301 | 2010-06-16 |
| 1134365554 | Gronsten-maier Dental Prof. LLC | Dentist | 240 E. 23rd Avenue, Mitchell, SD 57301 | 2009-01-07 |
| Find all providers in zip 57301 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699972422 | Avera Queen of Peace | Specialist | 625 N Foster St Ste 200, Mitchell, SD 57301-2968 | 2007-06-27 |
| 1528275484 | Sport Clinic, PC | Specialist | 1222 E 7th Ave, Mitchell, SD 57301-0309 | 2007-05-17 |
| 1003927161 | James Valley Imaging Ltd | Specialist | 2200 N Kimball St Ste 700, Box 975, Mitchell, SD 57301-1195 | 2006-08-31 |
| 1245522622 | Avera Queen of Peace | Specialist | 2200 N Kimball St, Mitchell, SD 57301-1113 | 2011-05-04 |
| 1053548982 | Avera Queen of Peace | Specialist | 525 N Foster St, Mitchell, SD 57301-2966 | 2009-06-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598211179 | Barbara Samson | Specialist | 1807 William Street, Sturgis, SD 57785 | 2016-09-01 |
| 1144776345 | Mary Wood-fossen | Specialist | 1807 Williams, Sturgis, SD 57785 | 2016-08-28 |
| 1407204175 | Melissa Krogman | Specialist | 1451 Mcclellan Dr, Huron, SD 57350-3860 | 2016-06-02 |
| 1558716621 | Sharon Buseman Egan | Specialist | 409 E 41st St, Sioux Falls, SD 57105-5837 | 2016-04-26 |
| 1518375906 | Angela Schrader | Specialist | 2708 S Sandstone Cir, Sioux Falls, SD 57103-6511 | 2014-07-29 |
| 1952647760 | Klancy Tindall | Specialist | 1311 Vander Horck Avenue, Britton, SD 57430-0939 | 2012-12-26 |
| 1184996696 | Robert Eugene Polcyn | Specialist | 617 S 15th Street, Hot Springs, SD 57747-5127 | 2012-01-30 |
| 1013149681 | Ann M Host | Specialist | 404 Jackson Ave, Murdo, SD 57559 | 2009-08-17 |
| 1427213602 | Peggy Flynn Settle-kenefick | Specialist | 521 6th St Ste 102, Brookings, SD 57006-1461 | 2008-07-27 |
| 1366610339 | Judy Ann Zimbelman | Specialist | 7500 E Pine Lake Dr, Sioux Falls, SD 57110-6241 | 2008-02-13 |
| Find all providers with the same taxonomy | ||||
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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.