Individual provider Active NPI

Heather Lyn Bergfors, D.C.

  • Chiropractor
  • Seattle, WA
National Provider Identifier
1013962976
Registry record updated Sep 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CM00034169 Issued in WA
Practice address
2719 E Madison St
Suite 203
Seattle, WA 98112-4752
Phone
(206) 568-7545
Fax
(206) 568-8298
NPI assigned
May 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CM00034169 WA Primary

Addresses

Primary practice location

2719 E Madison St
Suite 203
Seattle, WA 98112-4752

Mailing address

4742 42ND Ave SW
PMB #527
Seattle, WA 98116-4553
Phone (206) 914-3417

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151210002380 WA Practitioner - Chiropractic 7911208251 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2719 E Madison St
Suite 203
Seattle, WA 98112-4752
Phone (205) 568-7545

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CM00034169WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Heather L .Bergfors DC PS CurrentSince Jan 31, 2007 Accepting new patients
Treehouse Ventures NW, Inc PastSince Nov 14, 2015 Accepting new patients

Locations

5001 California Ave SW
Ste 111
Seattle, WA 98136
Phone (206) 257-4126

2719 E Madison St
Ste 203
Seattle, WA 98112
Phone (206) 568-7545

4742 42nd Ave SW
Seattle, WA 98116
Phone (206) 595-4181

Networks

  • WA PPO C-SNP
  • devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252627200000",
    "number": "1013962976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4742 42ND AVE SW",
            "address_2": "PMB #527",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981164553",
            "telephone_number": "206-914-3417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2719 E MADISON ST",
            "address_2": "SUITE 203",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981124752",
            "telephone_number": "206-568-7545",
            "fax_number": "206-568-8298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGFORS",
        "first_name": "HEATHER",
        "middle_name": "LYN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-22",
        "last_updated": "2009-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CM00034169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.