Mirayah Bergmann, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT609 Issued in ME

Practice address

11 Academy LN
North Bridgton, ME 04057-1808

Phone

(207) 691-5843

Fax

(207) 810-2020

NPI assigned

Mar 24, 2025

Last updated

Mar 24, 2025By the provider in NPPES

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

Other names 1

• Mia Bergmann Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1742774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742774400000",
    "number": "1508667510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 ACADEMY LN",
            "city": "NORTH BRIDGTON",
            "state": "ME",
            "postal_code": "040571808",
            "telephone_number": "207-691-5843",
            "fax_number": "207-810-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 ACADEMY LN",
            "city": "NORTH BRIDGTON",
            "state": "ME",
            "postal_code": "040571808",
            "telephone_number": "207-691-5843",
            "fax_number": "207-810-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGMANN",
        "first_name": "MIRAYAH",
        "credential": "ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-24",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "ME",
            "license": "AT609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIA",
            "last_name": "BERGMANN",
            "credential": "ATC, LAT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Julliane M Forbes, N.D.
• Cody Marean, ATC, PES
• Joseph Zenon Sawicki, ATC, CSCS

• Athletic Trainer in North Bridgton, ME
• Providers in North Bridgton, ME by specialty
• Athletic Trainer in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2025; 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.