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Colleen Marie Berg

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

100 Rosebrook Way, Southcoast Physician Services, Inc. 3rd Floor, Wareham, MA 02571-2097

(508) 273-4900 (508) 985-2000

PECOS Enrollment

This provider is enrolled in PECOS as COLLEEN BERG.

Based on the most recent information from CMS, provider Colleen Marie Berg is legally eligible to order and refer claims for DME and PMD services only.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records today at 9:43 AM.

Profile Details

Provider ID
1477628527
Provider Type
Individual
Full Name
Berg, Colleen Marie
Title
Mrs.
Credential
N.P.

Gender
Female
Sole Proprietor
No
Enumeration Date
11/22/2006
Last Updated
6/16/2011

Contact Information

Practice Location

100 Rosebrook Way, Southcoast Physician Services, Inc. 3rd Floor, Wareham, MA 02571-2097

(508) 273-4900

(508) 273-4901

Mailing Location

370 Faunce Corner Road, Southcoast Physician Services, Inc., North Dartmouth, MA 02747-1271

(508) 985-2000

(508) 985-2001

Provider Taxonomies

Code	Description	License
Code 363L00000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License RN142625 Massachusetts
Code 363L00000X	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 142625 Massachusetts
Code 363LP0200X	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 142625 Massachusetts

Colleen Marie Berg

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

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Roy, Samantha Jane

Cote, Khoryn

Arsenault, Elise

Vieira, Sherry Ann

Obin, Catherine A

Catalan, Judith A

Cabral, Victoria Marie