Alycean Maryrae Bergh, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

6018 Issued in MN

Practice address

10950 Club West Pkwy Ste 190
Blaine, MN 55449-4679

Phone

(763) 400-4940

NPI assigned

Jan 5, 2015

Last updated

Jan 12, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Chiropractic

Education

Northwestern College of Chiropractic, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Club West Chiropractic, PAGroup PAC ID 7416310610, 3 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Club West Chiropractic PA

  • Chiropractor
  • Blaine, MN
  • NPI 1427447432
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1420416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1326436064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10950 CLUB WEST PKWY STE 190",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554494679",
            "telephone_number": "763-400-4940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10950 CLUB WEST PKWY STE 190",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554494679",
            "telephone_number": "763-400-4940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGH",
        "first_name": "ALYCEAN",
        "middle_name": "MARYRAE",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-05",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6018",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MN",
            "license": "1076",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Hamilton Belden
• Jeremy John Beltz, R.N.
• Ashley Ann Berens, OD
• Berg Therapy, LLC
• Andrea Berge, DDS
• Kathleen G Bergman, MA LP
• Kellie C Bernal Delgado, LICSW
• Better and Brighter Mental Health Services Inc
• Emily M Betz, OTR/L
• Beyond Grace Transport LLC

• Chiropractor in Blaine, MN
• Providers in Blaine, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.