Individual provider Active NPI

Sarah Bergman, DO

  • Family Medicine Physician
  • Selmer, TN
National Provider Identifier
1114505666
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
6175 Issued in TN
Practice address
270 E Court Ave
Selmer, TN 38375-2304
Phone
(731) 541-9490
NPI assigned
Mar 29, 2021
Last updated
Apr 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 6175 TN Primary

Addresses

Primary practice location

270 E Court Ave
Selmer, TN 38375-2304

Mailing address

270 E Court Ave
Selmer, TN 38375-2304
Phone (731) 541-9490

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, TN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240306000217 MS Practitioner - Family Practice 6103229695
I20250430003271 TN Practitioner - Family Practice 6103229695 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
William Carey University College of Osteopathic Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Tennessee Medical Group IncGroup PAC ID 3971781006, 190 clinicians
Boa Vida Hospital of Aberdeen Ms LLCGroup PAC ID 0244505840, shared by 26 NPIs, 70 clinicians

Practice addresses (Care Compare)

270 E Court Ave
Suite B
Selmer, TN 38375-0000
Phone (731) 645-7932

502 S Chestnut St
Aberdeen, MS 39730-3337
Phone (662) 319-8844

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
West Tennessee Medical Group Inc Family Medicine CurrentSince Apr 28, 2025 Accepting new patients
Boa Vida Hospital of Aberdeen, Ms LLC CurrentSince Dec 27, 2023 Accepting new patients
Boa Vida Hospital of Aberdeen, Ms, LLC CurrentSince Dec 27, 2023 Accepting new patients
Jackson Surgical Associates. PA Past Accepting new patients

Locations

400 S Chestnut St
Aberdeen, MS 39730
Phone (662) 369-2455

710 E Main St
Adamsville, TN 38310
Phone (731) 632-3383

426 White Ave
Henderson, TN 38340
Phone (731) 989-2174

257 Bancorp South Pkwy
Jackson, TN 38305
Phone (731) 512-1283

620 Skyline Dr
Jackson, TN 38301
Phone (731) 425-5000

270 E Court Ave
#B
Selmer, TN 38375
Phone 73164579322931

Organizations & group practices 4

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

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1114505666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 E COURT AVE",
            "city": "SELMER",
            "state": "TN",
            "postal_code": "383752304",
            "telephone_number": "731-541-9490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 E COURT AVE",
            "city": "SELMER",
            "state": "TN",
            "postal_code": "383752304",
            "telephone_number": "731-541-9490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGMAN",
        "first_name": "SARAH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-29",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "6175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Selmer, TN

Sources for this page

Verify at the official NPI Registry.