NPIMap

Individual provider Active NPI

Katrin S Bergeron, MD

  • Family Medicine Physician
  • Raymond, NH
National Provider Identifier
1508931890
Registry record updated Sep 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
13574 Issued in NH
Practice address
128 Route 27
Raymond, NH 03077-1220
Phone
(603) 895-3351
Fax
(603) 895-0773
NPI assigned
Nov 21, 2006
Last updated
Sep 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 13574 NH Primary

Addresses

Primary practice location

128 Route 27
Raymond, NH 03077-1220

Mailing address

128 Route 27
Raymond, NH 03077-1220
Phone (603) 895-3351

Other practice location 1

207 S Main St
Newmarket, NH 03857-1843
Phone (603) 292-7292

Other identifiers 1

IdentifierTypeStateIssuer
3072721MedicaidNH

Other names 1

  • Katrin Bergeron-Killough Professional name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071106000767 NH Practitioner - Family Practice 0547357626 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lamprey Health Care IncGroup PAC ID 3577535319, 52 clinicians

Practice addresses (Care Compare)

128 Route 27
Raymond, NH 03077-1220
Phone (603) 895-3351

207 S Main St
Newmarket, NH 03857-1843
Phone (603) 659-3106

22 Prospect St
Nashua, NH 03060-3924
Phone (603) 883-1626

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13574NHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lamprey Health Care Inc CurrentSince Jan 1, 2014 Accepting new patients
Lamprey Health Care Inc Family Medicine Current Accepting new patients
Lamprey Health Care Inc Family Medicine CurrentSince Jan 1, 2014 Accepting new patients
County of Rockingham Past Accepting new patients

Locations

22 Prospect St
Nashua, NH 03060
Phone (603) 883-1626

207 S Main St
Newmarket, NH 03857
Phone (603) 659-3106

128 State Route 27
Raymond, NH 03077

Interoperability endpoints

  • Direct secure messaging: katrin.bergeron.1@28541.direct.athenahealth.com
  • Direct secure messaging: kbergeron507173@direct.bilh.masshiway.net

Organizations & group practices 4

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 6

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": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632355200000",
    "number": "1508931890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 ROUTE 27",
            "city": "RAYMOND",
            "state": "NH",
            "postal_code": "030771220",
            "telephone_number": "603-895-3351",
            "fax_number": "603-895-0773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 ROUTE 27",
            "city": "RAYMOND",
            "state": "NH",
            "postal_code": "030771220",
            "telephone_number": "603-895-3351",
            "fax_number": "603-895-0773"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "207 S Main St",
            "address_purpose": "LOCATION",
            "city": "Newmarket",
            "state": "NH",
            "postal_code": "038571843",
            "country_code": "US",
            "telephone_number": "603-292-7292",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERGERON",
        "first_name": "KATRIN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NH",
            "license": "13574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3072721",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATRIN",
            "last_name": "BERGERON-KILLOUGH",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Raymond, NH

Sources for this page

Verify at the official NPI Registry.