Molly Bergen, MD
Individual provider Active NPI Obstetrics & Gynecology Physician · Nashville, TN
NPI 1760011696 · NPPES record last updated Jun 25, 2024
Key facts
- NPI
- 1760011696
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- 1760011696 (TN)
- Practice address
- 1410 Janie Ave
Nashville, TN 37216-2821 - Phone
- (817) 937-0955
- NPI assigned
- Apr 2, 2020
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200415001313 | TN | Order and Referring Only - Obstetrics/Gynecology |
3678903697 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1760011696 | TN | MD | Obstetrics & Gynecology Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 1760011696 | TN | Yes |
Addresses
Primary practice location
1410 Janie Ave
Nashville, TN 37216-2821
Mailing address
1410 Janie Ave
Nashville, TN 37216-2821
Other providers in Nashville, TN
- Kelli Lynn Berg
- Mackenzie Berg
- Marion Berg
- Nathaniel Karl Berg
- Anna Bergeman
- Berger and Burrow Enterprises Inc.
- Berger and Burrow Enterprises Inc.
- Brian L Berger
- Cameron Scott Berger
- Christine T Berger
All providers in Nashville, TN · Obstetrics & Gynecology Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 25, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.