Individual provider Active NPI

David Moshe Bergman, M.D.

  • Pediatrics Physician
  • Alpharetta, GA
National Provider Identifier
1467412791
Registry record updated Oct 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
051116 Issued in GA
Practice address
9570 Nesbit Ferry Rd
Suite 201
Alpharetta, GA 30022-6859
Phone
(770) 640-8119
Fax
(770) 988-5553
NPI assigned
Mar 23, 2006
Last updated
Oct 17, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 051116 GA Primary
Pediatrics Physician 208000000X 3085901-1205 UT

Addresses

Primary practice location

9570 Nesbit Ferry Rd
Suite 201
Alpharetta, GA 30022-6859

Mailing address

9570 Nesbit Ferry Rd
Suite 201
Alpharetta, GA 30022-6859
Phone (770) 640-8119

Other identifiers 1

IdentifierTypeStateIssuer
000938704IMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
051116GAMDPediatrics Physician
3085901-1205UTMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Pediatricplace PC Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: dbergman6484@choa.gadirect.net

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476662400000",
    "number": "1467412791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9570 NESBIT FERRY RD",
            "address_2": "SUITE 201",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300226859",
            "telephone_number": "770-640-8119",
            "fax_number": "770-988-5553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9570 NESBIT FERRY RD",
            "address_2": "SUITE 201",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300226859",
            "telephone_number": "770-640-8119",
            "fax_number": "770-988-5553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGMAN",
        "first_name": "DAVID",
        "middle_name": "MOSHE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2016-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "051116",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "UT",
            "license": "3085901-1205",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000938704I",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2016; 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.