Kyle Steven Bergeson, DPT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

9049 Issued in AZ

Practice address

3654 W Anthem Way Ste B102
Anthem, AZ 85086-0455

Phone

(623) 551-9706

NPI assigned

Sep 13, 2010

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1284336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284336000000",
    "number": "1619284577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17204 N 46TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85032",
            "telephone_number": "605-359-5807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3654 W ANTHEM WAY STE B102",
            "city": "ANTHEM",
            "state": "AZ",
            "postal_code": "850860455",
            "telephone_number": "623-551-9706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGESON",
        "first_name": "KYLE",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-13",
        "last_updated": "2010-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "AZ",
            "license": "9049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vincen Bateman Jr.
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• Beechtree Diagnostics LLP
• Hannah Beer, LPC
• Tara Berkley
• Nicole Besana, PT
• Best Life Family Medicine PLLC
• Better Health Chiropractic
• Nicole Renee Bishop, NP

• Orthopedic Physical Therapist in Anthem, AZ
• Providers in Anthem, AZ by specialty
• Orthopedic Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2010; 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.