MR. MATTHEW LEE BERRY (NPI# 1710254982) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710254982 |
| Entity Type | Individual |
| Full Name | MR. MATTHEW LEE BERRY |
| Credential | R.PH. |
| Practice Address |
1717 Taylor Ave Racine WI 53403-2405 |
| Mailing Address |
34226 Venice Park Rd Delafield WI 53018-1323 |
| Practice Telephone | 2626726183 |
| Practice Fax Number | 2626190499 |
| Mailing Telephone | 2624340033 |
| Enumeration Date | 2011-11-16 |
| Last Update Date | 2017-04-26 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | 5302028240 | MI | Pharmacy Service Providers |
| N | 183500000X | Pharmacist | 051-037143 | IL | Pharmacy Service Providers |
| Y | 183500000X | Pharmacist | 14075-040 | WI | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083134225 | Matthew Thomas Berry | Physical Therapist | 41278 Margarita Rd Ste 102, Temecula, CA 92591-5579 | 2017-06-20 |
| 1730514514 | Matthew G Berry | Speech-Language Pathologist | 542 W Grand Blvd, Detroit, MI 48216-1439 | 2013-09-11 |
| 1659624781 | Matthew David Berry | Chiropractor | 1352 Sw 160th Avenue, Weston, FL 33326-1908 | 2012-10-26 |
| 1548887078 | Matthew Berry | Counselor | 222 Se 8th Ave Ste 212, Hillsboro, OR 97123-4218 | 2020-07-01 |
| 1013566736 | Matthew Allan Berry | Licensed Psychiatric Technician | 14677 Merrill Ave, Fontana, CA 92335 | 2019-09-05 |
| 1881248870 | Matthew J Berry | Physician Assistant | 2500 English Creek Ave Ste 1300, Egg Harbor Township, NJ 08234-5598 | 2019-07-29 |
| 1598257040 | Matthew Berry | Counselor | 600 Johnson Ave Ste C5, Bohemia, NY 11716-2669 | 2018-05-31 |
| 1215472626 | Matthew Berry | Physician Assistant | 960 S 1st Ave, Iowa City, IA 52245-5210 | 2016-12-21 |
| 1083168892 | Matthew Berry | Counselor | 5900 Us Route 60, Suite B, Ashland, KY 41102-9508 | 2016-08-09 |
| 1851750947 | Matthew Berry | Counselor | 201 W Springdale Ave, Knoxville, TN 37917-5158 | 2016-02-17 |
| Street Address |
1717 TAYLOR AVE |
| City | RACINE |
| State | WI |
| Zip Code | 53403-2405 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356441018 | Susan F Mickel | Psychologist | 1717 Taylor Ave, Racine, WI 53403-2405 | 2006-09-23 |
| 1811595671 | Wallace Edward Brandies Jr. | Counselor | 1717 Taylor Ave, Racine, WI 53403-2405 | 2020-10-14 |
| 1811503204 | Sarah Moran | Counselor | 1717 Taylor Ave, Racine, WI 53403-2405 | 2020-09-21 |
| 1013539477 | Kelly Jean Smith | Counselor | 1717 Taylor Ave, Racine, WI 53403-2405 | 2020-05-08 |
| 1417577230 | Alexandra Kim Kies | Social Worker | 1717 Taylor Ave, Racine, WI 53403-2405 | 2020-04-22 |
| 1336785336 | Selena Lamont Letteer | Counselor | 1717 Taylor Ave, Racine, WI 53403-2405 | 2019-11-25 |
| 1841832474 | Dora Ann Caldwell | Counselor | 1717 Taylor Ave, Racine, WI 53403-2405 | 2019-10-15 |
| 1043876451 | Darren L Taylor | Counselor | 1717 Taylor Ave, Racine, WI 53403-2405 | 2019-05-13 |
| 1689230179 | Kathleen B Campeau | Counselor | 1717 Taylor Ave, Racine, WI 53403-2405 | 2019-05-10 |
| 1689131534 | Melissa Hellen | Social Worker | 1717 Taylor Ave, Racine, WI 53403-2405 | 2019-02-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124676259 | Quality Care LLC | Clinic/Center | 2051 Mead St, Racine, WI 53403 | 2019-09-02 |
| 1073999355 | Wisconsin Lutheran Child & Family Service, Inc. | Social Worker | 6150 Taylor Avenue, Racine, WI 53403 | 2015-08-10 |
| 1457780496 | Pheynell Branch | Counselor | 1650 Wasington Ave, Racine, WI 53403 | 2013-11-08 |
| 1811278054 | Michelle Gloria Parisot | Psychologist | 1320 Wisconsin Ave., Racine, WI 53403 | 2011-09-01 |
| 1720372022 | Katie Hagen | Social Worker | 1717 Taylor Avenue, Racine, WI 53403 | 2011-06-03 |
| 1043431570 | Rita S Harris | Physical Therapy Assistant | Lakeshore Manor 1320 Wisconsin Avenue, Racine, WI 53403 | 2007-05-01 |
| 1336281336 | Linda J Hockensmith | Occupational Therapist | 4214 Sheridan Road, Racine, WI 53403 | 2007-02-13 |
| 1851447387 | Richard John Kemper | Dentist | 1509 Washington Ave, Racine, WI 53403 | 2007-01-26 |
| 1689760332 | Lester Leslie Higgenbottom | Counselor | 1820 Arlington Ave, Racine, WI 53403 | 2006-10-04 |
| 1114942315 | Access Medical Center, LLC | Clinic/Center | 4216 Old Green Bay Rd, Racine, WI 53403 | 2006-07-12 |
| Find all providers in zip 53403 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578164349 | Lynn Huynh | Pharmacist | 5695 Washington Ave, Racine, WI 53406 | 2020-11-06 |
| 1174930358 | Craig John Borgardt | Pharmacist | 6520 Hidden Creek Rd, Racine, WI 53402-9403 | 2014-07-19 |
| 1184038655 | Sunday Muniz | Pharmacist | 5220 Washington Ave, Ste 101, Racine, WI 53406-4228 | 2014-06-12 |
| 1033486592 | Paul Byron Anthony | Pharmacist | 5104 Cortland Ave, Racine, WI 53406 | 2011-11-28 |
| 1407132194 | John Thomas Keil | Pharmacist | 116 Northwood Dr, Racine, WI 53402-1938 | 2011-10-26 |
| 1982926507 | Mark Edward Buhler | Pharmacist | 2211 S Green Bay Rd, Racine, WI 53406-4919 | 2010-02-23 |
| 1033115787 | Mark A. Pelton | Pharmacist | 3801 Spring St, Racine, WI 53405-1667 | 2005-06-27 |
| 1144855008 | Jason Slaasted | Pharmacist | 4810 Washington Ave, Racine, WI 53406-4220 | 2020-03-11 |
| 1780218941 | Nicholas Kuroski | Pharmacist | 4810 Washington Ave, Racine, WI 53406-4220 | 2020-02-26 |
| 1871127407 | Ngan T Le | Pharmacist | 1920 Douglas Ave, Racine, WI 53402-4614 | 2020-02-22 |
| Find all providers in RACINE | ||||
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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.