Joseph Edward Bergstrom Sr., DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

03192 Issued in IA

Practice address

3200 W Kimberly Rd
Davenport, IA 52806-3059

Phone

(563) 421-1000

NPI assigned

Apr 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in IA, IL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: joseph.bergstrom@direct.genesishealth.com

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.

• Genesis Health System

  • Family Medicine Physician
  • Davenport, IA
  • NPI 1477654945

  Family Medicine, IL

  Medicare reassignment NPD
• Genesis Health System

  • General Acute Care Hospital
  • Silvis, IL
  • NPI 1427132604

  IL

  Medicare reassignment NPD
• Genesis Health System

  • Clinic/Center
  • Bettendorf, IA
  • NPI 1497772008

  IA

  Medicare reassignment
• Genesis Health System

  • Critical Access Hospital
  • De Witt, IA
  • NPI 1649368523
  NPD
• Genesis Health System

  • General Acute Care Hospital
  • Davenport, IA
  • NPI 1972542264
  NPD

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633219200000",
    "number": "1831154822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 W KIMBERLY RD",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528063059",
            "telephone_number": "563-421-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 W KIMBERLY RD",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528063059",
            "telephone_number": "563-421-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGSTROM",
        "first_name": "JOSEPH",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2021-10-03",
        "certification_date": "2021-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "03192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00363057",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "joseph.bergstrom@direct.genesishealth.com",
            "affiliation": "N",
            "endpointDescription": "Genesis Health System Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "3200 W Kimberly Rd",
            "city": "Davenport",
            "state": "IA",
            "country_code": "US",
            "postal_code": "528063059",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "joseph.bergstrom@direct.genesishealth.com",
            "affiliation": "N",
            "endpointDescription": "Genesis Health System Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "3200 W Kimberly Rd",
            "city": "Davenport",
            "state": "IA",
            "country_code": "US",
            "postal_code": "528063059",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Beverly A Benmoussa, NP
• Gena L.R. Benoit, MD
• Kaden Benson, DC
• Dean Berg, OPA
• Kirstin Ann Berger, DPT
• Andrew E Berkow, M.D.
• Adam D Berneking, MD
• David Nils Bernstrom II, LMSW
• Preston Eugene Berry, IADC & CRADC
• Joseph Michael Bertroche, D.O.,J.D.

• All providers in Davenport, IA
• Family Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.