Mary F. Bergum, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD00042807 Issued in WA

Practice address

3154 E 29TH Ave
Spokane, WA 99223-4852

Phone

(509) 448-4870

Fax

(888) 286-8401

NPI assigned

Nov 24, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

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 Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: john@maryfbergummdpllc.amazing-direct.com
• Direct secure messaging: mary_bergum_md@maryfbergummdpllc.amazing-direct.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Spokane Regional Health District

  • Public Health or Welfare Agency
  • Spokane, WA
  • NPI 1811954373
  NPD
• Columbia Medical Associates LLC

  • Family Medicine Physician
  • Spokane, WA
  • NPI 1154414761
  NPD (past)

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584576000000",
    "number": "1710053665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3154 E 29TH AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992234852",
            "telephone_number": "509-448-4870",
            "fax_number": "888-286-8401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3154 E 29TH AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992234852",
            "telephone_number": "509-448-4870",
            "fax_number": "888-286-8401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGUM",
        "first_name": "MARY",
        "middle_name": "F.",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-24",
        "last_updated": "2020-03-19",
        "certification_date": "2020-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00042807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "G8865268",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lynn Bergman, MD
• Melanie Kim Bergman, M.D.
• Anna Bergmann, LMT
• Bergs Foot Comfort Center
• Lauren Bergstedt, DPT
• Elizabeth Ann Berkers, LMP
• Cassandra Gabrielle Berkery
• Mahnoosh Berkey
• Mimi Berlinger, CDP
• Yelena V Berlova

• Family Medicine Physician in Spokane, WA
• Providers in Spokane, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2020; 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.