Christina Stauber Bergen, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-10241 Issued in NC

Practice address

110 S Main St
Boiling Springs, NC 28017-9797

Phone

(704) 406-4000

NPI assigned

Aug 13, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nirvana Hyperbaric Institute LLCGroup PAC ID 4587063136, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  NC

  Medicare reassignment
• Nirvana Hyperbaric Institute LLC

  • Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
  • Mooresville, NC
  • NPI 1982203618
  Care Compare group
• Gardner-Webb University

  • Voluntary or Charitable Agency
  • Boiling Springs, NC
  • NPI 1720265903
  NPD (past)
• Gardner-Webb University

  • Voluntary or Charitable Agency
  • Boiling Springs, NC
  • NPI 1881870038
  NPD (past)

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

{
    "created_epoch": "1565654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594771200000",
    "number": "1023664414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 EXECUTIVE PARK DR STE 100",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251838",
            "telephone_number": "704-237-4240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 S MAIN ST",
            "city": "BOILING SPRINGS",
            "state": "NC",
            "postal_code": "280179797",
            "telephone_number": "704-406-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGEN",
        "first_name": "CHRISTINA",
        "middle_name": "STAUBER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-13",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-10241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natasha Renee Alston
• Kristin Rosalie Bockelman, A.T.C.
• Boiling Springs Medical Associates, PA
• Jordan Bumgardner
• Caromont Medical Group Inc (Boiling Springs Medical Associates)
• Betsy Kay Clauss, ATC

• Physician Assistant in Boiling Springs, NC
• Providers in Boiling Springs, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.