Avni Bergum, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704293729 Issued in MI

Practice address

2109 Hamilton Rd Ste 217
Okemos, MI 48864-1700

Phone

(517) 580-0575

Fax

(517) 917-0826

NPI assigned

Dec 17, 2019

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

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Transitional Care Services LLCGroup PAC ID 6709165954, 45 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Elara Caring Home health agency, Jackson, MI, CCN 237274

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: avni.bergum.1@31855.direct.athenahealth.com
• Direct secure messaging: avni.bergum@mhmg-mi.direct.office.nextgen.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.

• Transitional Care Services, LLC

  dba HomeMD Housecall Services

  • Gerontology Nurse Practitioner
  • Waterford, MI
  • NPI 1174976807
  Medicare reassignment Care Compare group NPD
• McLaren Medical Group

  • Family Medicine Physician
  • Lapeer, MI
  • NPI 1346396066

  Nurse Practitioner

  Medicare reassignment NPD
• McLaren Health Management Group

  dba McLaren Palliative

  • Pain Medicine Physician
  • Port Huron, MI
  • NPI 1912072349
  Medicare reassignment
• McLaren Greater Lansing

  • Family Medicine Physician
  • Lansing, MI
  • NPI 1962808162

  Nurse Practitioner

  NPD
• McLaren Greater Lansing

  • Family Medicine Physician
  • Okemos, MI
  • NPI 1972878452
  NPD
• McLaren Medical Group

  • Diagnostic Radiology Physician
  • Lapeer, MI
  • NPI 1073650750
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Great Lakes Home Health Services, Inc.

  dba Elara Caring

  • Home Health Agency
  • Jackson, MI
  • NPI 1588642110
  Care Compare affiliation

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

{
    "created_epoch": "1576540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576540800000",
    "number": "1730727108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2109 HAMILTON RD STE 217",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488641700",
            "telephone_number": "517-580-0575",
            "fax_number": "517-917-0826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2109 HAMILTON RD STE 217",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488641700",
            "telephone_number": "517-580-0575",
            "fax_number": "517-917-0826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGUM",
        "first_name": "AVNI",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-17",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704293729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Juliana Benitah Botelho
• Brenda Sue Benjamin
• Bennett Optometry LLC (Clarkson Eyecare)
• Katelyn Bennett
• Christel Beretta, MA CCC-SLP
• Taryn Berkal
• Molly Berry
• Elissa Rae Besson, MS CCC-SLP
• Better Health Therapy Center LLC
• Ryan Beyea, DDS

• Nurse Practitioner in Okemos, MI
• Providers in Okemos, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.