NPI Code Detail JSON Logo

1417828211 NPI number — KELLIE EVA BERGER

NPI Number: 1417828211
Health Care Provider/Practitioner: KELLIE EVA BERGER

Information about “1417828211” NPI (KELLIE EVA BERGER) exists in 1417828211 in HTML format HTML  |  1417828211 in plain Text format TXT  |  1417828211 in PDF (Portable Document Format) PDF  |  1417828211 in an XML format XML  formats.

NPI Number : 1417828211 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1417828211",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BERGER",
    "FirstName": "KELLIE",
    "MiddleName": "EVA",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "727 S 5TH ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ALBION",
    "MailingAddressStateName": "NE",
    "MailingAddressPostalCode": "68620-1503",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "402-920-0086",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "102 W 9TH ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "NELIGH",
    "PracticeLocationAddressStateName": "NE",
    "PracticeLocationAddressPostalCode": "68756-1182",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "402-887-4151",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "09/15/2025",
    "LastUpdateDate": "09/15/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "225X00000X",
        "TaxonomyName": "Occupational Therapist",
        "LicenseNumber": "2649",
        "LicenseNumberStateCode": "NE",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.