Heather Ann Bergstrom, LAC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

ACU-279 Issued in ID

Practice address

9951 W St Lukes Dr
Nampa, ID 83687-7914

Phone

(208) 467-6700

NPI assigned

Jan 8, 2010

Last updated

Jul 11, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

State licenses

Practice roles

Locations

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.

• Vitality Acupuncture LLC

  • Acupuncturist
  • Meridian, ID
  • NPI 1205337656
  NPD Authorized official

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

{
    "created_epoch": "1262908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657497600000",
    "number": "1205166527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241",
            "fax_number": "888-361-5391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9951 W ST LUKES DR",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836877914",
            "telephone_number": "208-467-6700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 W. Barrett Dr.",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "ID",
            "postal_code": "83642",
            "country_code": "US",
            "telephone_number": "208-629-4920",
            "fax_number": "888-361-5391",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERGSTROM",
        "first_name": "HEATHER",
        "middle_name": "ANN",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-08",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "ID",
            "license": "ACU-279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Bennett, LCSW
• Melissa Crooks Bennett
• Bonnie Kay Benson, LPC-922
• Jocelyn Ashley Benton, PA-C
• Jennifer Estelle Berg
• Jessica Taylor Bernal, BA, MA, LPC
• Nate Berrian, MS
• Astride Berthon
• Jason Besecker, O.D.
• Best Homecare and Staffing LLC

• Acupuncturist in Nampa, ID
• Providers in Nampa, ID by specialty
• Acupuncturist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2022; 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.