Leona M Bergen, ACNPC-AG

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

Practice address

3100 Oak Grove Rd
Poplar Bluff, MO 63901-1573

Phone

(573) 776-2000

NPI assigned

Jan 24, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Leona M Davis Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Poplar Bluff Hma Physician Management, LLCGroup PAC ID 5092769703, 41 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Poplar Bluff Regional Medical Center Hospital, Poplar Bluff, MO, CCN 260119

Merit-based Incentive Payment System (MIPS)

Final score

91.41 of 100Reported as apm

Quality

79.26

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Poplar Bluff Hma Physician Management, LLC

  • Family Medicine Physician
  • Poplar Bluff, MO
  • NPI 1598710147

  MO

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Poplar Bluff Regional Medical Center LLC

  • General Acute Care Hospital
  • Poplar Bluff, MO
  • NPI 1700831724

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1485216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1831636281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2169 WAYNE 380",
            "city": "PATTERSON",
            "state": "MO",
            "postal_code": "639567106",
            "telephone_number": "573-944-0514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 OAK GROVE RD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639011573",
            "telephone_number": "573-776-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3098 Oak Grove Rd",
            "address_purpose": "LOCATION",
            "city": "Poplar Bluff",
            "state": "MO",
            "postal_code": "639018938",
            "country_code": "US",
            "telephone_number": "573-778-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERGEN",
        "first_name": "LEONA",
        "middle_name": "M",
        "credential": "ACNPC-AG",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-24",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MO",
            "license": "2016037517",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2019007962",
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "leona.bergen.1@8825.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "address_1": "3098 Oak Grove Rd",
            "city": "Poplar Bluff",
            "state": "MO",
            "country_code": "US",
            "postal_code": "639018938",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LEONA",
            "last_name": "DAVIS",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Donna Sue Belcher, BC-HIS
• Natalie Jamyle Bell, RDH
• Troy L Bell, O.D. & ASSOC PC
• Betty Jo Belmar, RN
• Laura Benningfield
• Anna Nicole Berger
• Kody Berrong, D.C.
• Stephanie Morgan Berrong, PHARM.D.
• Bethann Berry, M.A.
• Isabelle Rose Berry

• All providers in Poplar Bluff, MO
• General Acute Care Hospital in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.