Michael G Bergeson, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

0001264680 Issued in VA

Practice address

136 W 1300 North Cir
Centerville, UT 84014-1400

Phone

(804) 335-7421

NPI assigned

Dec 4, 2017

Sex

Male

Sole proprietor

No

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

Enrolled in UT

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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.

• Elite Anesthesia Associates

  • Certified Registered Nurse Anesthetist
  • Orem, UT
  • NPI 1922627975

  Nurse Anesthetist, Certified Registered, UT

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1512345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586476800000",
    "number": "1477068294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 W 1300 NORTH CIR",
            "city": "CENTERVILLE",
            "state": "UT",
            "postal_code": "840141400",
            "telephone_number": "804-335-7421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 W 1300 NORTH CIR",
            "city": "CENTERVILLE",
            "state": "UT",
            "postal_code": "840141400",
            "telephone_number": "804-335-7421"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10800 Midlothian Tpke Ste 265",
            "address_purpose": "LOCATION",
            "city": "North Chesterfield",
            "state": "VA",
            "postal_code": "232354700",
            "country_code": "US",
            "telephone_number": "804-594-2622",
            "fax_number": "804-594-0915",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERGESON",
        "first_name": "MICHAEL",
        "middle_name": "G",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-04",
        "last_updated": "2020-04-10",
        "certification_date": "2020-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0001264680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenna Bauer
• Beehive Homes of Centerville
• Aimee Catherine Beightol, DPT
• Mary Bench
• Cameron Peter Benson, PHARMD
• Stephanie Kay Bergeson
• Jeremiah Bailey Bitner
• Julie Blundell, LCSW
• Lorant Steve Bodo
• Joseph Taylor Bonham, DPT

• All providers in Centerville, UT
• Certified Registered Nurse Anesthetist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.