Ingrid Rose Bergen, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

46TA09024500 Issued in NJ

Practice address

635 W Wheat Rd
Vineland, NJ 08360-1973

Phone

(856) 692-6673

NPI assigned

Jul 8, 2015

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1436313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436313600000",
    "number": "1811370851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 W WHEAT RD",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083601973",
            "telephone_number": "856-692-6673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 W WHEAT RD",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083601973",
            "telephone_number": "856-692-6673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGEN",
        "first_name": "INGRID",
        "middle_name": "ROSE",
        "name_prefix": "Mrs.",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-08",
        "last_updated": "2015-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NJ",
            "license": "46TA09024500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Bendesky, MD
• Gerardine Benedetto
• Amanda Bennett, CPRS, CRSP
• Gina Bennett, CDA RDA
• Jennifer Lynn Benton
• Richard Berger, NP-C
• Christopher John Berkelbach, DPM
• Bridget D Bernardi, D.O.
• Amanda Bernardini
• Joseph Philip Bernardini, MD

• Occupational Therapy Assistant in Vineland, NJ
• Providers in Vineland, NJ by specialty
• Occupational Therapy Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.