Individual provider Active NPI

Mary Jo Bertsch, M.D.

  • Cardiovascular Disease Physician
  • Greenville, NC
National Provider Identifier
1184620056
Registry record updated Mar 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
9801170 Issued in NC
Practice address
2090 W Arlington Blvd
Ste B
Greenville, NC 27834-5727
Phone
(252) 758-3000
Fax
(252) 758-7107
NPI assigned
Jun 24, 2005
Last updated
Mar 16, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 9801170 NC Primary

Addresses

Primary practice location

2090 W Arlington Blvd
Ste B
Greenville, NC 27834-5727

Mailing address

2090 W Arlington Blvd
Ste B
Greenville, NC 27834-5727
Phone (252) 758-3000

Other identifiers 1

IdentifierTypeStateIssuer
891230GMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9801170NCMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Cardiology Consultants, P.a. Cardiovascular Disease PastSince Sep 1, 1999 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426464000000",
    "number": "1184620056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2090 W ARLINGTON BLVD",
            "address_2": "STE B",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278345727",
            "telephone_number": "252-758-3000",
            "fax_number": "252-758-7107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2090 W ARLINGTON BLVD",
            "address_2": "STE B",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278345727",
            "telephone_number": "252-758-3000",
            "fax_number": "252-758-7107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTSCH",
        "first_name": "MARY",
        "middle_name": "JO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-24",
        "last_updated": "2015-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NC",
            "license": "9801170",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891230G",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

Verify at the official NPI Registry.