Scott R Bergquist

Primary specialty

ContractorTaxonomy code 171W00000X

Practice address

2045 Oak Marsh Dr
Fernandina Beach, FL 32034-2462

Phone

(888) 684-8227

Fax

(888) 684-8227

NPI assigned

May 10, 2023

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1683676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1194415570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2045 OAK MARSH DR",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320342462",
            "telephone_number": "888-684-8227",
            "fax_number": "888-684-8227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 OAK MARSH DR",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320342462",
            "telephone_number": "888-684-8227",
            "fax_number": "888-684-8227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGQUIST",
        "first_name": "SCOTT",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-10",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Byron Frank Beall, LCSW, BCBA
• Noah Clayton-John Beaudry, D.C.
• Robin A Beck, MD
• Sharon Belcher, ARNP
• Benjamin N. Diller, DDS, PA
• Joshua R Beyl
• Beyond the Couch, LLC
• Kimberly H Bibb, APRN
• Ernest Paul Bicknell III, PSYD
• Joshua Owen Bietenholz, D.M.D.

• Contractor in Fernandina Beach, FL
• Providers in Fernandina Beach, FL by specialty
• Contractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; 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.