Organization Active NPI

Bergeson Chiropractic Clinic, P.C.

  • Chiropractor
  • Friendswood, TX
National Provider Identifier
1750512836
Registry record updated Sep 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC5413 Issued in TX
Legal business name
BERGESON CHIROPRACTIC CLINIC, P.C.
Practice address
351 E Parkwood Ave
Friendswood, TX 77546-5147
Phone
(281) 992-2225
NPI assigned
Aug 6, 2009
Last updated
Sep 29, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2011

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

Authorized official

Name
Dr. Keith L Bergeson, D.C.NPI 1194853820
Title
D.C.
Phone
(281) 992-2225

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC5413 TX Primary

Addresses

Primary practice location

351 E Parkwood Ave
Friendswood, TX 77546-5147

Mailing address

351 E Parkwood Ave
Friendswood, TX 77546-5147
Phone (281) 992-2225

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111101000342 TX Part B Supplier - Clinic/Group Practice 8628241064 Receives reassigned benefits from 1 practitioner
Practice locations: Friendswood, TX

National Provider Directory

National Provider Directory

Locations

351 E Parkwood Ave
Friendswood, TX 77546
Phone (281) 992-2225

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1249516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317254400000",
    "number": "1750512836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 E PARKWOOD AVE",
            "city": "FRIENDSWOOD",
            "state": "TX",
            "postal_code": "775465147",
            "telephone_number": "281-992-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 E PARKWOOD AVE",
            "city": "FRIENDSWOOD",
            "state": "TX",
            "postal_code": "775465147",
            "telephone_number": "281-992-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERGESON CHIROPRACTIC CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-06",
        "last_updated": "2011-09-29",
        "status": "A",
        "authorized_official_last_name": "BERGESON",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "D.C.",
        "authorized_official_telephone_number": "281-992-2225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "DC5413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Friendswood, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.