MS. LILLIAN M BERRY P.A. NPI 1619947850

NPI Information

NPI: 1619947850
Provider Name: MS. LILLIAN M BERRY, P.A.
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

Organization: EAST SOUTHERN MEDICAL GROUP, LLC

PECOS Registration: Yes

Address:
444 W OSBORN RD
SUITE 200
PHOENIX, AZ
ZIP 85013
Phone: (602) 230-1400
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MS. Lillian M Berry, P.A. is a medical physician assistant in Phoenix, AZ with 28 years of experience. MS. Lillian M Berry, P.A. NPI is 1619947850. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

444 W OSBORN RD
SUITE 200
PHOENIX, AZ
ZIP 85013-814
Phone: (602) 230-1400
Fax: (602) 230-7676

The NPI 1619947850 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/23/2006 and was last updated on 3/14/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	1959	ARIZONA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	Z136729	MEDICARE PIN	ARIZONA
2	P00845742	MEDICARE UPIN	ARIZONA
3	454025	MEDICAID	ARIZONA
4	3Z3956	OTHER	ARIZONA	HEALTHNET

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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