Individual provider Active NPI

Matthew Bertram, DC

  • Chiropractor
  • Evansville, IN
National Provider Identifier
1619689783
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08003353A Issued in IN
Practice address
111 S Green River Rd Ste H
Evansville, IN 47715-7338
Phone
(812) 464-4470
NPI assigned
Dec 20, 2022
Last updated
Jan 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08003353A IN Primary

Addresses

Primary practice location

111 S Green River Rd Ste H
Evansville, IN 47715-7338

Mailing address

111 S Green River Rd Ste H
Evansville, IN 47715-7338
Phone (812) 464-4470

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221222002304 IN Practitioner - Chiropractic 3476923095 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

111 S Green River Rd
Suite H
Evansville, IN 47715-7338
Phone (812) 464-4470

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bertram Chiropractic and Wellness LLC Chiropractor CurrentSince Jan 1, 2024 Accepting new patients
Gilkey Chiropractic Clinic, Inc Chiropractor CurrentSince Dec 20, 2022 Accepting new patients

Locations

111 S Green River Rd
Ste H
Evansville, IN 47715
Phone (812) 464-4470

7580 Peachwood Dr
Newburgh, IN 47630
Phone (812) 853-2997

Organizations & group practices 2

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": "1671494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1619689783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S GREEN RIVER RD STE H",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477157338",
            "telephone_number": "812-464-4470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S GREEN RIVER RD STE H",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477157338",
            "telephone_number": "812-464-4470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTRAM",
        "first_name": "MATTHEW",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-20",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08003353A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; 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.