Shelly Kay Bergum, NP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

17398 Issued in CA

Practice address

2315 Stockton Blvd
Sacramento, CA 95817-2201

Phone

(916) 734-5538

Fax

(916) 734-0907

NPI assigned

Jul 25, 2007

Sex

Female

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

Merit-based Incentive Payment System (MIPS)

Final score

83.15 of 100Reported as group

Quality

64.8

Promoting interoperability

100

Improvement activities

40

Cost

68.65

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185321600000",
    "number": "1487854691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 STOCKTON BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172201",
            "telephone_number": "916-734-5538",
            "fax_number": "916-734-0907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 STOCKTON BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172201",
            "telephone_number": "916-734-5538",
            "fax_number": "916-734-0907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGUM",
        "first_name": "SHELLY",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-25",
        "last_updated": "2007-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "17398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tess Berghoff, LMFT
• Nicholas Ryan Berghorst, DO
• Crystelle Camille Berginc, FNP
• Lars F Berglund, MD PHD
• Melissa A. Bergstrom, MD
• Biniam Berhane, PHARMD
• Philmon Berhane
• Selemawit Tekleab Berhane
• Neil Beri, MD
• Maria Lourdes Beristain, RN, BSN

• Acute Care Nurse Practitioner in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Acute Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.

Verify at the official NPI Registry.