Kyle Bergmann, RD
Individual provider Active NPI Registered Dietitian · Corvallis, OR
NPI 1215205232 · NPPES record last updated Dec 5, 2011
Key facts
- NPI
- 1215205232
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 000899 (OR)
- Practice address
- 3517 NW Samaritan Dr Ste 200
Corvallis, OR 97330-3767 - Phone
- (541) 768-6429
- Fax
- (541) 768-6514
- NPI assigned
- Dec 5, 2011
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000899 | OR | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Good Samaritan Hospital Corvallis | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 000899 | OR | Yes |
Addresses
Primary practice location
3517 NW Samaritan Dr Ste 200
Corvallis, OR 97330-3767
Mailing address
3517 NW Samaritan Dr Ste 200
Corvallis, OR 97330-3767
Phone (541) 768-6429
Other providers in Corvallis, OR
- Lynn A. Bentson
- Amer Benyounes
- Poojitha Reddy Beravol
- Kathrine Ashley Berg
- Meraina C Berge
- Seth Philip Berkowitz
- Leslie B Berman
- Patricia Berman
- Alexandra Bernal
- Christina Bernards
All providers in Corvallis, OR · Registered Dietitian in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 5, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.