Madisen Bergh, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT297866 Issued in CA

Practice address

11930 Heritage Oak PL Ste 9
Auburn, CA 95603-2458

Phone

(530) 887-8785

NPI assigned

Aug 17, 2016

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

Other identifiers 2

Other names 1

• Madisen Clark Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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 and National Provider Directory roles.

• Spring Physical Therapy

  • Physical Therapist
  • Shoreline, WA
  • NPI 1548127483
  NPD Authorized official
• Sutter Valley Medical Foundation

  • Multi-Specialty Clinic/Center
  • Modesto, CA
  • NPI 1669846986
  NPD
• Sutter Valley Medical Foundation

  • Durable Medical Equipment & Medical Supplies
  • Tracy, CA
  • NPI 1720930712
  NPD
• Sutter Valley Medical Foundation

  • Multi-Specialty Clinic/Center
  • Sacramento, CA
  • NPI 1952327256

  Physical Therapist

  NPD
• Therapeutic Associates Inc

  • Physical Therapist
  • Bothell, WA
  • NPI 1114376563
  NPD (past)
• Therapeutic Associates Inc

  • Physical Therapist
  • Portland, OR
  • NPI 1700862000
  NPD (past)
• University of Washington

  • General Acute Care Hospital
  • Seattle, WA
  • NPI 1326002049
  NPD (past)

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

{
    "created_epoch": "1471392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609286400000",
    "number": "1396290698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 255228",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958655228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11930 HERITAGE OAK PL STE 9",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956032458",
            "telephone_number": "530-887-8785"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5420 Barnes Ave NW",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981073839",
            "country_code": "US",
            "telephone_number": "206-789-7975",
            "fax_number": "206-782-6177",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3121 E Madison St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981124259",
            "country_code": "US",
            "telephone_number": "206-324-5389",
            "fax_number": "206-324-5391",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11815 Education St",
            "address_purpose": "LOCATION",
            "city": "Auburn",
            "state": "CA",
            "postal_code": "956022410",
            "country_code": "US",
            "telephone_number": "530-888-4500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERGH",
        "first_name": "MADISEN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-17",
        "last_updated": "2020-12-30",
        "certification_date": "2020-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "60655072",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT297866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396290698",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01853414",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MADISEN",
            "last_name": "CLARK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alisa Bennett
• Caryn Bennett, PT
• Karen Berendt
• Jeffrey M Bergeson, D.O.
• Keifer Bergeson, DO
• Magrit Bergmann
• Maureen Carol Bern, OTR
• Julia Renee Bernasconi
• Debra Bernbeck
• Elaine Bernie

• Physical Therapist in Auburn, CA
• Providers in Auburn, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.