Edmond X Bergeron III, M.P.

Primary specialty

Prescribing (Medical) PsychologistTaxonomy code 103TP0016X

License

606MP Issued in LA

Practice address

806 Jefferson Ter
New Iberia, LA 70560-5727

Phone

(337) 365-4945

NPI assigned

Oct 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Iberia Comprehensive Community Health Center,Inc.Group PAC ID 6204817828, 35 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Iberia Comprehensive Community Health Center,Inc.

  • Federally Qualified Health Center (FQHC)
  • New Iberia, LA
  • NPI 1922046549

  LA

  Medicare reassignment Care Compare group NPD
• Iberia Comprehensive Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Lafayette, LA
  • NPI 1316244338
  Care Compare group NPD
• Iberia Comprehensive Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Deridder, LA
  • NPI 1457235368
  Care Compare group NPD
• Geriatric Psychological Services of Louisiana Apc

  • Psychologist
  • Lafayette, LA
  • NPI 1326325127
  NPD (past) Authorized official
• Iberia Comprehensive Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Lafayette, LA
  • NPI 1568731602
  Care Compare group
• Iberia Comprehensive Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Many, LA
  • NPI 1114341666
  Care Compare group
• Iberia Comprehensive Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Abbeville, LA
  • NPI 1134166556
  Care Compare group
• Iberia Comprehensive Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Leesville, LA
  • NPI 1235634486
  Care Compare group
• Iberia Comprehensive Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • St. Martinville, LA
  • NPI 1821286899
  Care Compare group
• Iberia Comprehensive Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • New Iberia, LA
  • NPI 1831877653
  Care Compare group
• Iberia Comprehensive Community Health Center,Inc.

  • Federally Qualified Health Center (FQHC)
  • Merryville, LA
  • NPI 1891020012
  Care Compare group

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1235211798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 JEFFERSON TER",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705605727",
            "telephone_number": "337-365-4945",
            "fax_number": "337-376-6860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 JEFFERSON TER",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705605727",
            "telephone_number": "337-365-4945"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1009 CHARITY ST",
            "address_purpose": "LOCATION",
            "city": "Abbeville",
            "state": "LA",
            "postal_code": "70510",
            "country_code": "US",
            "telephone_number": "337-893-3443",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "317 Dernier St",
            "address_purpose": "LOCATION",
            "city": "Saint Martinville",
            "state": "LA",
            "postal_code": "705823809",
            "country_code": "US",
            "telephone_number": "337-342-2566",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1004 Surrey St",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "LA",
            "postal_code": "705016143",
            "country_code": "US",
            "telephone_number": "337-456-6768",
            "fax_number": "337-456-8690",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3909 Avenue Bonne Terre",
            "address_purpose": "LOCATION",
            "city": "New Iberia",
            "state": "LA",
            "postal_code": "705633057",
            "country_code": "US",
            "telephone_number": "337-322-0455 x2144",
            "fax_number": "337-373-0129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERGERON",
        "first_name": "EDMOND",
        "middle_name": "X",
        "name_suffix": "III",
        "credential": "M.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "LA",
            "license": "606MP",
            "primary": false
        },
        {
            "code": "103TP0016X",
            "taxonomy_group": "",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "LA",
            "license": "606MP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1660841",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Believe Iberia Counseling LLC
• Shameka Bellard
• Belle Teche Nursing & Rehabilitation Center, LLC
• Shannon Michelle Benjamin, RN,WCC
• Lauryn Madisyn Bennett
• Douglas A Bernard, MD
• Better Vision of New Iberia, Inc
• John Lamar Beyt III, D.D.S.
• Harold G Bienvenu III, M.D.
• Bill'S Medical Transportation

• All providers in New Iberia, LA
• Prescribing (Medical) Psychologist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.