Active NPI
Stephen Bergman, D.O.
- Family Medicine Physician
- Grants Pass, OR
National Provider Identifier
1669475562
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- DO21112
- Practice address
- 741 NE 6TH St
Grants Pass, OR 97526-1556 - Phone
- (541) 471-2701
- Fax
- (541) 471-1166
- NPI assigned
- May 24, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | DO21112 | OR | Primary |
Addresses
Primary practice location
741 NE 6TH St
Grants Pass, OR 97526-1556
Mailing address
741 NE 6TH St
Grants Pass, OR 97526-1556
Phone (541) 471-2701
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150730013936 | OR | Order and Referring Only - Family Practice | 8123017225 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1116892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184112000000",
"number": "1669475562",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "741 NE 6TH ST",
"city": "GRANTS PASS",
"state": "OR",
"postal_code": "975261556",
"telephone_number": "541-471-2701",
"fax_number": "541-471-1166"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "741 NE 6TH ST",
"city": "GRANTS PASS",
"state": "OR",
"postal_code": "975261556",
"telephone_number": "541-471-2701",
"fax_number": "541-471-1166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERGMAN",
"first_name": "STEPHEN",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-05-24",
"last_updated": "2007-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "DO21112",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grants Pass, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.