Active NPI
Teresa R Bergman, RN
- Registered Nurse
- Lees Summit, MO
National Provider Identifier
1801050927
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 115107
- Practice address
- 901 NE Independence Ave
Lees Summit, MO 64086-5544 - Phone
- (816) 246-8000
- NPI assigned
- Jul 17, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 115107 | MO | Primary |
Addresses
Primary practice location
901 NE Independence Ave
Lees Summit, MO 64086-5544
Mailing address
3715 S Beatrice CT
Independence, MO 64055-3812
Phone (816) 478-4353
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 115107 | MO | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222128000000",
"number": "1801050927",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3715 S BEATRICE CT",
"city": "INDEPENDENCE",
"state": "MO",
"postal_code": "640553812",
"telephone_number": "816-478-4353"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 NE INDEPENDENCE AVE",
"city": "LEES SUMMIT",
"state": "MO",
"postal_code": "640865544",
"telephone_number": "816-246-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERGMAN",
"first_name": "TERESA",
"middle_name": "R",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-07-17",
"last_updated": "2008-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MO",
"license": "115107",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lees Summit, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.