Thomas J Bergeron Jr.

Primary specialty

Home Modifications ContractorTaxonomy code 171WH0202X

Practice address

39080 Rosaryville Rd
Ponchatoula, LA 70454-7000

Phone

(985) 974-3231

Fax

(225) 294-6217

NPI assigned

Jun 15, 2008

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1213488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213488000000",
    "number": "1407016298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39080 ROSARYVILLE RD",
            "city": "PONCHATOULA",
            "state": "LA",
            "postal_code": "704547000",
            "telephone_number": "985-974-3231",
            "fax_number": "225-294-5170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39080 ROSARYVILLE RD",
            "city": "PONCHATOULA",
            "state": "LA",
            "postal_code": "704547000",
            "telephone_number": "985-974-3231",
            "fax_number": "225-294-6217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGERON",
        "first_name": "THOMAS",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-15",
        "last_updated": "2008-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171WH0202X",
            "taxonomy_group": "",
            "desc": "Contractor, Home Modifications",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2008; 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.