Carol J Bergbower, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

041212985 Issued in IL

Practice address

1000 N Allen St
Robinson, IL 62454-1114

Phone

(618) 544-3131

Fax

(618) 546-2614

NPI assigned

Jun 9, 2006

Last updated

Oct 29, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 7

Other names 1

• Carol J Bergbower Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Crawford Hospital DistrictGroup PAC ID 7719898071, shared by 8 NPIs, 71 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Crawford Memorial Hospital Hospital, Robinson, IL, CCN 141343

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: carol.bergbower@crawfordmh.cernerdirect.com

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.

• Crawford Hospital District

  dba Crawford Memorial Hospital and Health Services

  • Critical Access Hospital
  • Robinson, IL
  • NPI 1265493720
  Medicare reassignment NPD
• Crawford Hospital District

  dba Crawford Memorial Hospital

  • Internal Medicine Physician
  • Robinson, IL
  • NPI 1861423287
  Medicare reassignment NPD
• CJB Anesthesia Services Inc

  • Certified Registered Nurse Anesthetist
  • Robinson, IL
  • NPI 1811936230
  Authorized official Same address or phone
• Crawford Hospital District

  dba CMH Specialty Clinic-Newton

  • Urology Physician
  • Newton, IL
  • NPI 1265309405
  NPD

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

• Crawford Hospital District

  dba CMH Specialty Clinic-Newton

  • Urology Physician
  • Newton, IL
  • NPI 1265309405

  Hospital

  Care Compare affiliation
• Crawford Hospital District

  dba Crawford Memorial Hospital and Health Services

  • Critical Access Hospital
  • Robinson, IL
  • NPI 1265493720
  Care Compare affiliation

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1346281763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N ALLEN ST",
            "city": "ROBINSON",
            "state": "IL",
            "postal_code": "624541114",
            "telephone_number": "618-544-3131",
            "fax_number": "618-546-2614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N ALLEN ST",
            "city": "ROBINSON",
            "state": "IL",
            "postal_code": "624541114",
            "telephone_number": "618-544-3131",
            "fax_number": "618-546-2614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGBOWER",
        "first_name": "CAROL",
        "middle_name": "J",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "041212985",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "01732004",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLACK LUNG",
            "identifier": "020354300",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "540347",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PIN",
            "identifier": "P00042146",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IRS TAX ID",
            "identifier": "200009980",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP",
            "identifier": "DA2630",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "041212985",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "carol.bergbower@crawfordmh.cernerdirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1000 N Allen St",
            "city": "Robinson",
            "state": "IL",
            "country_code": "US",
            "postal_code": "624541114",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CAROL",
            "last_name": "BERGBOWER",
            "middle_name": "J",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Vickie Becker, MD
• Devan Paige Beeman, PTA
• Mindy Beisner, PTA
• Samantha Bennett
• Rikki Benson, M.A. CCC-SLP
• Mary Katherine Blankenbaker, CCC-SLP
• Board Members-Crawford County Government (Crawford County Health Department)
• Angela Marie Bogard
• Letizia Boin, BA
• Nicholas Christopher Brissey, DPM

• Certified Registered Nurse Anesthetist in Robinson, IL
• Providers in Robinson, IL by specialty
• Certified Registered Nurse Anesthetist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2020; 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.