Jacob Andrew Berggren, DO

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

1400 W 22ND St
Sioux Falls, SD 57105-1554

Phone

(605) 322-5737

NPI assigned

Apr 6, 2023

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

Other names 1

• Jake Andrew Berggren Other name

Medicare fee-for-service enrollment

Enrolled in SD

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1680739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680739200000",
    "number": "1699460642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18807 CHANDLER ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681361224",
            "telephone_number": "402-639-7325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 W 22ND ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051554",
            "telephone_number": "605-322-5737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGGREN",
        "first_name": "JACOB",
        "middle_name": "ANDREW",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-06",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAKE",
            "last_name": "BERGGREN",
            "middle_name": "ANDREW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Alaina Berger, RBT
• Jennifer Christine Berger, M.D.
• Timothy Francis Berger, DDS
• Demetria Antoinette Bergeson
• Lance Joseph Bergeson, M.A.
• Taylor Alexandra Bergh, MA, ATC
• Jeanette F Berglin, CRNA
• Michelle Lee Bergst, DPT
• Anthony J Bergstrom
• Heather Jean Berney, M.D.

• All providers in Sioux Falls, SD
• Student in an Organized Health Care Education/Training Program in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2023; 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.

Verify at the official NPI Registry.