Heather M Bergerud OD Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

2621 Issued in MN

Legal business name

HEATHER M BERGERUD OD INC

Practice address

3745 Louisiana Ave S
St. Louis Park, MN 55426

Phone

(952) 922-4427

Fax

(952) 922-4761

NPI assigned

Nov 15, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Heather Marie Bergerud, ODNPI 1669545018

Title

Chief Officer

Phone

(952) 403-1694

Specialties & licenses 1

Addresses

Other names 1

• Heather M Bergerud OD Other name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Heather Marie Bergerud, OD

  • Optometrist
  • St Louis Park, MN
  • NPI 1669545018
  Authorized official Same address or phone

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497828842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 GREENLEAF CT.",
            "city": "CHANHASSEN",
            "state": "MN",
            "postal_code": "55317",
            "telephone_number": "952-403-1694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3745 LOUISIANA AVE S",
            "city": "ST. LOUIS PARK",
            "state": "MN",
            "postal_code": "55426",
            "telephone_number": "952-922-4427",
            "fax_number": "952-922-4761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEATHER M BERGERUD OD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BERGERUD",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CHIEF OFFICER",
        "authorized_official_telephone_number": "952-403-1694",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heather M Bergerud OD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Healingpoint Recovery Inc.
• Healthier People LLC (E Squared Health)
• Hannah Heaston-Lee, PA
• Jennifer Erin Heath, PHARM.D.
• Heather Johnson LLC
• Keith M Heaton, M.D.
• Michael B Hebert, M.D.
• Devin Hedlund, MD
• Brittney L Hegg, RDN
• Melissa Ann Hegland-Smith, MA

• Optometrist in St Louis Park, MN
• Providers in St Louis Park, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.