Individual provider Active NPI

Pamela L. Bergeron, RNC WHNP

  • Nurse Practitioner
  • Amarillo, TX
National Provider Identifier
1235314063
Registry record updated Mar 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
500603 Issued in TX
Practice address
7620 Wallace Blvd
Amarillo, TX 79124-2154
Phone
(806) 359-5468
Fax
(806) 359-7201
NPI assigned
Dec 28, 2007
Last updated
Mar 23, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 500603 TX Primary

Addresses

Primary practice location

7620 Wallace Blvd
Amarillo, TX 79124-2154

Mailing address

7620 Wallace Blvd
Amarillo, TX 79124-2154
Phone (806) 359-5468

Other names 1

  • Sarah Bergeron Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090708000571 TX Practitioner - Nurse Practitioner 0042362840 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Texas Southwestern Medical School at Dallas, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Panhandle Obstetrics and GynecologyGroup PAC ID 7810993391, 8 clinicians

Practice addresses (Care Compare)

7620 Wallace Blvd
Amarillo, TX 79124-2154
Phone (806) 359-5468

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
500603TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Panhandle Obstetrics & Gynecology CurrentSince Mar 16, 2011 Accepting new patients

Locations

7620 Wallace Blvd
Amarillo, TX 79124
Phone (806) 359-5468

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1198800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300838400000",
    "number": "1235314063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7620 WALLACE BLVD",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791242154",
            "telephone_number": "806-359-5468",
            "fax_number": "806-359-7201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7620 WALLACE BLVD",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791242154",
            "telephone_number": "806-359-5468",
            "fax_number": "806-359-7201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGERON",
        "first_name": "PAMELA",
        "middle_name": "L.",
        "credential": "RNC WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-28",
        "last_updated": "2011-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "500603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARAH",
            "last_name": "BERGERON",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Amarillo, TX

Sources for this page

Verify at the official NPI Registry.