Individual provider Active NPI

Caroline Elizabeth Bergfalk, D.C.

  • Chiropractor
  • Bayfield, CO
National Provider Identifier
1497875496
Registry record updated Sep 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3573 Issued in CO
Practice address
175 S Clover LN
Suite 5
Bayfield, CO 81122-9651
Phone
(970) 884-9779
Fax
(970) 884-0847
NPI assigned
Mar 31, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3573 CO Primary

Addresses

Primary practice location

175 S Clover LN
Suite 5
Bayfield, CO 81122-9651

Mailing address

PO Box 1035
Bayfield, CO 81122-9651
Phone (970) 884-9779

Other identifiers 1

IdentifierTypeStateIssuer
P1652991OtherBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050906000606 CO Practitioner - Chiropractic 7517999097 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

175 S Clover Dr
Suite 5
Bayfield, CO 81122-1035
Phone (970) 884-9779

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3573COMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Pine River Chiropractic Inc Chiropractor CurrentSince Jan 1, 1994 Accepting new patients

Locations

175 S Clover Dr
Ste 5
Bayfield, CO 81122
Phone (970) 739-8220

Interoperability endpoints

  • Direct secure messaging: linnea16@prci0001.direct.chirotouch.md

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.

NPI Registry JSON

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

{
    "created_epoch": "1175299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190246400000",
    "number": "1497875496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1035",
            "city": "BAYFIELD",
            "state": "CO",
            "postal_code": "811229651",
            "telephone_number": "970-884-9779",
            "fax_number": "970-884-0847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 S CLOVER LN",
            "address_2": "SUITE 5",
            "city": "BAYFIELD",
            "state": "CO",
            "postal_code": "811229651",
            "telephone_number": "970-884-9779",
            "fax_number": "970-884-0847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGFALK",
        "first_name": "CAROLINE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-31",
        "last_updated": "2007-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "3573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "P1652991",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayfield, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.

Verify at the official NPI Registry.