Individual provider Active NPI

Janet M Bergeron, M.D.

  • Family Medicine Physician
  • Norwood, MN
National Provider Identifier
1669559001
Registry record updated Jul 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
30882 Issued in MN
Practice address
406 N Faxon Rd
Norwood, MN 55368-9507
Phone
(952) 467-2888
Fax
(952) 467-3258
NPI assigned
Nov 1, 2006
Last updated
Jul 25, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2012

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 30882 MN Primary

Addresses

Primary practice location

406 N Faxon Rd
Norwood, MN 55368-9507

Mailing address

406 N Faxon Rd
Norwood, MN 55368-9507
Phone (952) 467-2888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30882MNMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343174400000",
    "number": "1669559001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 N FAXON RD",
            "city": "NORWOOD",
            "state": "MN",
            "postal_code": "553689507",
            "telephone_number": "952-467-2888",
            "fax_number": "952-467-3258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 N FAXON RD",
            "city": "NORWOOD",
            "state": "MN",
            "postal_code": "553689507",
            "telephone_number": "952-467-2888",
            "fax_number": "952-467-3258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGERON",
        "first_name": "JANET",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2012-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "30882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwood, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2012; 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.