Andrew Mark Bergeron, CDCAII

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

169471 Issued in OH

Practice address

301 W 1St St
Dayton, OH 45402-3033

Phone

(937) 528-3923

NPI assigned

Oct 15, 2019

Last updated

Oct 15, 2019By 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 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/voaohin/r4/

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.

• Volunteers of America Ohio & Indiana

  • Addiction (Substance Use Disorder) Counselor
  • Mansfield, OH
  • NPI 1518580141
  NPD (past)

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

{
    "created_epoch": "1571097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571097600000",
    "number": "1144862897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 W 1ST ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454023033",
            "telephone_number": "937-528-3923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 W 1ST ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454023033",
            "telephone_number": "937-528-3923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGERON",
        "first_name": "ANDREW",
        "middle_name": "MARK",
        "name_prefix": "Mr.",
        "credential": "CDCAII",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-15",
        "last_updated": "2019-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "169471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "andrew.bergeron@recoverydefined.com",
            "affiliation": "N",
            "address_1": "301 W 1st St",
            "city": "Dayton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454023033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tyra Lindsey Benzinger, AA
• Samantha Berberich, CDCA
• Aaron Loomis Berenson, MD
• Nathaniel Wos Berg
• Annamarie Berger, PCC
• Anna Bergman
• Dustin Michael Bergman
• Fehmi B Berkay, MD
• Aaron Eli Berman, MD
• Devin Berna

• Addiction (Substance Use Disorder) Counselor in Dayton, OH
• Providers in Dayton, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2019; 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.