Individual provider Active NPI

Melissa Bergman, FNP-C

  • Family Nurse Practitioner
  • Holland, OH
National Provider Identifier
1740011097
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.0037172 Issued in OH
Practice address
7059 Orchard Centre Dr
Holland, OH 43528-7961
Phone
(567) 297-4177
NPI assigned
Aug 9, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.0037172 OH Primary

Addresses

Primary practice location

7059 Orchard Centre Dr
Holland, OH 43528-7961

Mailing address

PO Box 932958
Cleveland, OH 44193-0028

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20241113000508 OH Practitioner - Nurse Practitioner 0244764272 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Little Clinic of Ohio LLCGroup PAC ID 7719087584, 212 clinicians

Practice addresses (Care Compare)

7059 Orchard Centre Dr
Holland, OH 43528-7961
Phone (567) 297-4117

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Little Clinic of Ohio LLC Family CurrentSince Oct 9, 2024 Accepting new patients

Locations

199 Graceland Blvd
Columbus, OH 43214
Phone (614) 410-2814

Interoperability endpoints

  • Direct secure messaging: melissa.bergman@krogerhealth.eclinicaldirectplus.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1723161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1740011097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 932958",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441930028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7059 ORCHARD CENTRE DR",
            "city": "HOLLAND",
            "state": "OH",
            "postal_code": "435287961",
            "telephone_number": "567-297-4177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGMAN",
        "first_name": "MELISSA",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-09",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0037172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, OH

Sources for this page

Verify at the official NPI Registry.