Active NPI
Angela K Bergan, MSPT
- Physical Therapist
- Waukee, IA
National Provider Identifier
1700104858
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 02781
- Practice address
- 50 E Hickman Rd
Waukee, IA 50263-5011 - Phone
- (515) 216-2999
- Fax
- (515) 216-2990
- NPI assigned
- May 13, 2010
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 02781 | IA | Primary |
Addresses
Primary practice location
50 E Hickman Rd
Waukee, IA 50263-5011
Mailing address
50 E Hickman Rd
Waukee, IA 50263-5011
Phone (515) 471-9243
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700104858 | Medicaid | IA |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1273708800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321833600000",
"number": "1700104858",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50 E HICKMAN RD",
"city": "WAUKEE",
"state": "IA",
"postal_code": "502635011",
"telephone_number": "515-471-9243",
"fax_number": "515-471-9319"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 E HICKMAN RD",
"city": "WAUKEE",
"state": "IA",
"postal_code": "502635011",
"telephone_number": "515-216-2999",
"fax_number": "515-216-2990"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERGAN",
"first_name": "ANGELA",
"middle_name": "K",
"credential": "MSPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-05-13",
"last_updated": "2011-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IA",
"license": "02781",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1700104858",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waukee, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.