Jacob Bergman

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

083849 Issued in IA

Practice address

1409 Clark St
Des Moines, IA 50314-1964

Phone

(515) 643-6500

NPI assigned

Mar 15, 2017

Last updated

Mar 15, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 3, 2025 through Jan 3, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• House of Mercy

  • Substance Abuse Rehabilitation Facility
  • Des Moines, IA
  • NPI 1821155284
  NPD (past)
• New Heights Counseling Resources Inc

  • Mental Health Counselor
  • Urbandale, IA
  • NPI 1689797193
  NPD (past)

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

{
    "created_epoch": "1489536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489536000000",
    "number": "1295276897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 NORTH BUXTON STREET",
            "city": "INDIANOLA",
            "state": "IA",
            "postal_code": "50125",
            "telephone_number": "515-358-7608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 CLARK ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503141964",
            "telephone_number": "515-643-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGMAN",
        "first_name": "JACOB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-15",
        "last_updated": "2017-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "083849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin Berger, MD
• Skye Berger
• Anna Marie Bergida, CADC
• Bergman Cosmetic Surgery, PC
• Bradley David Bergman, D.O.
• James Jay Bergman, M.D.
• Megan Bergman, PA-C
• Ronald Steven Bergman, D.O.
• Miranda Bergmann, ARNP
• Steffany Bergmann, LMSW

• Mental Health Counselor in Des Moines, IA
• Providers in Des Moines, IA by specialty
• Mental Health Counselor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.