Richard A Bergstrand, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0522098 Issued in KS

Practice address

550 Pope Ave
Fort Leavenworth, KS 66027-2332

Phone

(913) 684-6601

Fax

(913) 684-6612

NPI assigned

Nov 2, 2005

Last updated

Nov 7, 2024By the provider in NPPES

Sex

Male

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

Enrolled in KS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1275524845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 POPE AVE",
            "city": "FT. LAVENWORTH",
            "state": "KS",
            "postal_code": "66027",
            "telephone_number": "913-684-6601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 POPE AVE",
            "city": "FORT LEAVENWORTH",
            "state": "KS",
            "postal_code": "660272332",
            "telephone_number": "913-684-6601",
            "fax_number": "913-684-6612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGSTRAND",
        "first_name": "RICHARD",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "0522098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexa Bell
• Brent (NMN) Bengtson, LSCSW, LCSW, ACSW
• Brenda Joy Benson, PH.D.
• John Duane Benz, RPH, MBA
• Brandy Leigh Berdou, R.N.
• Dana Bilik, RDH
• Robert Allen Bischoff, PH.D.
• Sherry Blakney-Johnson, LPN
• Tracy Katherine Bono-Johnson, L.P.N.
• Diane Marie Booth

• Family Medicine Physician in Fort Leavenworth, KS
• Providers in Fort Leavenworth, KS by specialty
• Family Medicine Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.