Provider Demographics
NPI:1164619409
Name:KATHERINE J. BERGER, D.P.M.
Entity Type:Organization
Organization Name:KATHERINE J. BERGER, D.P.M.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:JOAN
Authorized Official - Last Name:BERGER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:402-474-4766
Mailing Address - Street 1:3401 O ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-1541
Mailing Address - Country:US
Mailing Address - Phone:402-474-4766
Mailing Address - Fax:402-474-5957
Practice Address - Street 1:747 N BURLINGTON AVE STE 308
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-4478
Practice Address - Country:US
Practice Address - Phone:402-462-2331
Practice Address - Fax:402-461-4054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-01
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE219213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE480010032OtherRR MEDICARE
NE470747185OtherMIDLANDS CHOICE
NE47074718513Medicaid
NE470747195OtherCHAMPUS
NE02561OtherBC/BS
NE091290OtherMEDICARE