Active NPI
Aubrey Lynn Bergerson, MS, CCC-SLP
- Speech-Language Pathologist
- Fargo, ND
National Provider Identifier
1154798577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 1349
- Practice address
- 3700 54TH St S
Fargo, ND 58104-7471 - Phone
- (701) 356-5890
- Fax
- (701) 499-6693
- NPI assigned
- Sep 2, 2015
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 1349 | ND | Primary |
Addresses
Primary practice location
3700 54TH St S
Fargo, ND 58104-7471
Mailing address
3350 42ND St S
Apt 306
Fargo, ND 58104-6950
Phone (701) 261-4895
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1349 | ND | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1441152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1441152000000",
"number": "1154798577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3350 42ND ST S",
"address_2": "APT 306",
"city": "FARGO",
"state": "ND",
"postal_code": "581046950",
"telephone_number": "701-261-4895"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3700 54TH ST S",
"city": "FARGO",
"state": "ND",
"postal_code": "581047471",
"telephone_number": "701-356-5890",
"fax_number": "701-499-6693"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERGERSON",
"first_name": "AUBREY",
"middle_name": "LYNN",
"credential": "MS, CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-02",
"last_updated": "2015-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "ND",
"license": "1349",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.