Larry Bergere, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

44166 Issued in GA

Practice address

105 Carnegie PL
St 103
Fayetteville, GA 30214-3980

Phone

(770) 716-7999

Fax

(770) 716-8444

NPI assigned

Oct 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Internal Medicine

Education

University of Miami, LM Miller School of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeast Medical Group, P.C.Group PAC ID 3577559673, 139 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centerwell Home Health Home health agency, Kennesaw, GA, CCN 117027
• Central Home Health Care, an Amedisys Company Home health agency, Douglasville, GA, CCN 117050
• Centerwell Home Health Home health agency, Peachtree City, GA, CCN 117137
• Piedmont Fayette Hospital Hospital, Fayetteville, GA, CCN 110215
• Northside Hospital Hospital, Atlanta, GA, CCN 110161
• Southern Regional Medical Center Hospital, Riverdale, GA, CCN 110165
• Piedmont Henry Hospital Hospital, Stockbridge, GA, CCN 110191

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DIJIBA

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Southeast Medical Group, P.C.

  • Family Medicine Physician
  • Alpharetta, GA
  • NPI 1235296054
  Medicare reassignment Care Compare group NPD
• Harsch and Osborne MD PC

  • Internal Medicine Physician
  • Stockbridge, GA
  • NPI 1699081885
  NPD

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

• Amedisys Georgia, LLC

  • Home Health Agency
  • Douglasville, GA
  • NPI 1437117090
  Care Compare affiliation
• CHMG of Griffin, LLC

  • Home Health Agency
  • Peachtree City, GA
  • NPI 1730119538
  Care Compare affiliation
• Fayette Community Hospital, Inc.

  • General Acute Care Hospital
  • Fayetteville, GA
  • NPI 1528027240
  Care Compare affiliation
• Healthfield Home Health, LLC

  • Home Health Agency
  • Kennesaw, GA
  • NPI 1770513574
  Care Compare affiliation
• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1457396079
  Care Compare affiliation
• Piedmont Henry Hospital, Inc.

  • General Acute Care Hospital
  • Stockbridge, GA
  • NPI 1225034333
  Care Compare affiliation
• Prime Healthcare Foundation - Southern Regional, LLC

  • General Acute Care Hospital
  • Riverdale, GA
  • NPI 1154795581
  Care Compare affiliation

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609966613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 CARNEGIE PL",
            "address_2": "ST 103",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302143980",
            "telephone_number": "770-716-7999",
            "fax_number": "770-716-8444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 CARNEGIE PL",
            "address_2": "ST 103",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302143980",
            "telephone_number": "770-716-7999",
            "fax_number": "770-716-8444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGERE",
        "first_name": "LARRY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "44166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Bennett, LPC
• Monica Renee Bennett, TRANSPORTATION
• Stephanie Bennette, NP
• Deborah Bentley, NP
• Stacey Bentley, RBT
• Charles A Bergstrom, M.D.
• Tashinea Bernadin, DO
• Nicketa Bernard, NP
• Andrew Bernstein
• Jasmine Berry, FNP-C

• Internal Medicine Physician in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.