Active NPI
Jerod Joseph Bergman, D.C.
- Neurology Chiropractor
- Rhinelander, WI
National Provider Identifier
1477630564
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Chiropractor
- License
- 3888-012
- Practice address
- 401 S Pelham St
Rhinelander, WI 54501-3314 - Phone
- (715) 362-2300
- Fax
- (715) 362-2305
- NPI assigned
- Nov 1, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Chiropractor | 111NN0400X | 3888-012 | WI | Primary |
Addresses
Primary practice location
401 S Pelham St
Rhinelander, WI 54501-3314
Mailing address
401 S Pelham St
Rhinelander, WI 54501-3314
Phone (715) 362-2300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38942100 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Northwestern College of Chiropractic, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
401 S Pelham St
Rhinelander, WI 54501-3314
Phone (715) 362-2300
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3888-012 | WI | MD | Neurology Chiropractor |
| 3888 | WI | MD | Nurse Practitioner |
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.
-
- Neurology Chiropractor
- Rhinelander, WI
- NPI 1881892636
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1477630564",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 S PELHAM ST",
"city": "RHINELANDER",
"state": "WI",
"postal_code": "545013314",
"telephone_number": "715-362-2300",
"fax_number": "715-362-2305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 S PELHAM ST",
"city": "RHINELANDER",
"state": "WI",
"postal_code": "545013314",
"telephone_number": "715-362-2300",
"fax_number": "715-362-2305"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERGMAN",
"first_name": "JEROD",
"middle_name": "JOSEPH",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111NN0400X",
"taxonomy_group": "",
"desc": "Chiropractor, Neurology",
"state": "WI",
"license": "3888-012",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "38942100",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rhinelander, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.