Inge C Bertram
Individual provider Active NPI Family Nurse Practitioner · Page, AZ
NPI 1013103787 · NPPES record last updated Sep 9, 2022
Key facts
- NPI
- 1013103787
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 277709 (AZ)
- Practice address
- 827 Vista Ave
Page, AZ 86040-7501 - Phone
- (928) 645-9675
- NPI assigned
- Sep 17, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Tuba City Regional Health Care Corporation
Practice addresses (Care Compare)
167 Main St
Tcrhcc Mobile Medical Clinic
Tuba City, AZ 86045-0600
Phone (928) 283-2501
Hospital & facility affiliations
- Tuba City Regional Health Care Corporation
- Flagstaff Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250521001024 | TX | Practitioner - Nurse Practitioner | 8224118716 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tuba City Regional Health Care Corporation | Current |
Accepting new patients | |
| Tuba City Regional Health Care Corporation | Current | Accepting new patients | |
| Tuba City Regional Health Care Corporation | Current |
Accepting new patients | |
| Canyonlands Community Health Care | Past |
Accepting new patients | |
| Canyonlands Community Health Care | Past | Accepting new patients | |
| The Healthcaring Clinic of Florida, LLC | Family | Past | Accepting new patients |
| Canyonlands Community Health Care | Nurse Practitioner | Past |
Accepting new patients |
| Canyonlands Community Health Care | Past | Accepting new patients |
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 277709 | AZ | Yes |
Addresses
Primary practice location
827 Vista Ave
Page, AZ 86040-7501
Mailing address
827 Vista Ave
Page, AZ 86040-7501
Phone (928) 645-9675
Other providers in Page, AZ
- Peter V Banks
- Banner Hospital Based Physicians Arizona LLC
- Banner Physician Specialists Arizona LLC
- Banner Primary Care Physicians Arizona LLC
- Matthew Barkman
- BHSM Rehabilitation, LLC
- Janeen Bjork
- Rebecca Bradshaw
- Merril Bryan
- Natacha Tatiana Bryan
All providers in Page, AZ · Family Nurse Practitioner in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 9, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.