Individual provider Active NPI

Jennifer Ann Bergeron, RN

  • Registered Nurse
  • Lawrence, MA
National Provider Identifier
1245845924
Registry record updated Sep 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN2302450 Issued in MA
Practice address
34 Haverhill St
Lawrence, MA 01841-2884
Phone
(978) 689-6665
Fax
(978) 722-3013
NPI assigned
Sep 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN2302450 MA Primary

Addresses

Primary practice location

34 Haverhill St
Lawrence, MA 01841-2884

Mailing address

7 Carleton CT
Methuen, MA 01844-2901
Phone (978) 846-4961

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN2302450MAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1599696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599696000000",
    "number": "1245845924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 CARLETON CT",
            "city": "METHUEN",
            "state": "MA",
            "postal_code": "018442901",
            "telephone_number": "978-846-4961",
            "fax_number": "978-722-3013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 HAVERHILL ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018412884",
            "telephone_number": "978-689-6665",
            "fax_number": "978-722-3013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGERON",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "name_prefix": "Miss",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-10",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2302450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2020; 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.