Individual provider Active NPI

Brandon Bergeron, MD

  • Internal Medicine Physician
  • Bay Minette, AL
National Provider Identifier
1497486625
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
48283 Issued in AL
Practice address
2115 Hand Ave Ste B
Bay Minette, AL 36507-4149
Phone
(251) 937-7100
Fax
(251) 937-9882
NPI assigned
Jun 20, 2022
Last updated
Aug 6, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X 48283 AL Primary

Addresses

Primary practice location

2115 Hand Ave Ste B
Bay Minette, AL 36507-4149

Mailing address

188 Hospital Dr Ste 402
Fairhope, AL 36532-2018

Other identifiers 1

IdentifierTypeStateIssuer
000000OtherNONMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250819000557 AL Practitioner - Internal Medicine 5991204760 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Louisiana State University School of Medicine in New Orleans, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Imc-North Baldwin Primary Plus, LLCGroup PAC ID 4880857952, 3 clinicians

Practice addresses (Care Compare)

2115 Hand Ave
Suite B
Bay Minette, AL 36507-4149
Phone (251) 937-7100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
48283ALMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Imc-North Baldwin Primary Plus, LLC CurrentSince Sep 1, 2025 Accepting new patients

Locations

2115 Hand Ave
Ste B
Bay Minette, AL 36507
Phone (251) 937-7100

Interoperability endpoints

  • Direct secure messaging: bbergeron114260@directinfirmaryhealth.org

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1655683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1497486625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "188 HOSPITAL DR STE 402",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365322018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 HAND AVE STE B",
            "city": "BAY MINETTE",
            "state": "AL",
            "postal_code": "365074149",
            "telephone_number": "251-937-7100",
            "fax_number": "251-937-9882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGERON",
        "first_name": "BRANDON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-20",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "48283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONMEDICARE",
            "identifier": "000000",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Minette, AL

Sources for this page

Verify at the official NPI Registry.