Active NPI
Hailey Bergner
- Developmental Therapist
- Providence, RI
National Provider Identifier
1700649654
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental Therapist
- Practice address
- 50 Holden St
Providence, RI 02908-5757 - Phone
- (401) 274-2211
- NPI assigned
- Feb 2, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | Primary |
Addresses
Primary practice location
50 Holden St
Providence, RI 02908-5757
Mailing address
345 Kettle Pond Dr
Wakefield, RI 02879-5465
Phone (401) 644-5430
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1706832000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706832000000",
"number": "1700649654",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "345 KETTLE POND DR",
"city": "WAKEFIELD",
"state": "RI",
"postal_code": "028795465",
"telephone_number": "401-644-5430"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 HOLDEN ST",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029085757",
"telephone_number": "401-274-2211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERGNER",
"first_name": "HAILEY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-02-02",
"last_updated": "2024-02-02",
"certification_date": "2024-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.