Stephen Henry Berghofer, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01043612A Issued in IN

Practice address

112 S Harrison St
Alexandria, IN 46001-2067

Phone

(765) 724-7627

NPI assigned

Nov 23, 2005

Last updated

Oct 3, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Madison County Community Health Centers Inc

  • Family Medicine Physician
  • Anderson, IN
  • NPI 1770668030
  NPD (past)

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

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222992000000",
    "number": "1124001094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10330 N MERIDIAN ST",
            "address_2": "SUITE 201",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462901024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 S HARRISON ST",
            "city": "ALEXANDRIA",
            "state": "IN",
            "postal_code": "460012067",
            "telephone_number": "765-724-7627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGHOFER",
        "first_name": "STEPHEN",
        "middle_name": "HENRY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-23",
        "last_updated": "2008-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01043612A",
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "IN",
            "license": "01043612A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200062200",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD GROUP",
            "identifier": "DC3600",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD INDIVIDUAL",
            "identifier": "P00616368",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexandria Community School Corp.
• Rebecca Ann Allen, MSN
• Paula Jean Balensiefer, MLHCA
• Barbara Hannah
• Shannon Deann Belt
• Amanda Renee Buell, RBT
• Shana Kaye Carmin, NP
• City of Alexandria (Alexandria Fire Department)
• Cleanslate Medical Group of Indiana LLC
• Community Hospitals of Indiana (Gerald Irwin MD)

• Family Medicine Physician in Alexandria, IN
• Providers in Alexandria, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.