Active NPI
Nathaniel Bergman
- Geriatric Pharmacist
- Midland, MI
National Provider Identifier
1073884136
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Pharmacist
- License
- 5302039668
- Practice address
- 215 Fast Ice Dr
Midland, MI 48642 - Phone
- (888) 837-3636
- NPI assigned
- Jan 21, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Pharmacist | 1835G0303X | 5302039668 | MI | Primary |
Addresses
Primary practice location
215 Fast Ice Dr
Midland, MI 48642
Mailing address
4700 E Parish Rd
Midland, MI 48642-9784
Phone (989) 965-4554
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302039668 | MI | MD | Geriatric Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Region VII Complete Community Care | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- In Home Supportive Care Agency
- Bay City, MI
- NPI 1942849492
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1327104000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478476800000",
"number": "1073884136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4700 E PARISH RD",
"city": "MIDLAND",
"state": "MI",
"postal_code": "486429784",
"telephone_number": "989-965-4554"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 FAST ICE DR",
"city": "MIDLAND",
"state": "MI",
"postal_code": "48642",
"telephone_number": "888-837-3636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERGMAN",
"first_name": "NATHANIEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-01-21",
"last_updated": "2016-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "1835G0303X",
"taxonomy_group": "",
"desc": "Pharmacist, Geriatric",
"state": "MI",
"license": "5302039668",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Midland, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.