Active NPI
Charles Kenneth Bergdolt, DO
- Aerospace Medicine Physician
- Pensacola, FL
National Provider Identifier
1194392241
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Aerospace Medicine Physician
- License
- O-1734
- Practice address
- 220 Hovey Rd
Pensacola, FL 32508-1044 - Phone
- (850) 542-2933
- NPI assigned
- Jun 8, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 8288488 | AL | |
| Aerospace Medicine Physician | 2083A0100X | O-1734 | ID | Primary |
Addresses
Primary practice location
220 Hovey Rd
Pensacola, FL 32508-1044
Mailing address
220 Hovey Rd
Pensacola, FL 32508-1044
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
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8288488 | AL | MD | Family Medicine Physician |
| O-1734 | ID | MD | Aerospace Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750809600000",
"number": "1194392241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "220 HOVEY RD",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325081044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 HOVEY RD",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325081044",
"telephone_number": "850-542-2933"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERGDOLT",
"first_name": "CHARLES",
"middle_name": "KENNETH",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-06-08",
"last_updated": "2025-06-25",
"certification_date": "2025-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AL",
"license": "8288488",
"primary": false
},
{
"code": "2083A0100X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Aerospace Medicine",
"state": "ID",
"license": "O-1734",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pensacola, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.