Active NPI
Lisa Marguerite Bergkoetter, RN
- Registered Nurse
- Philadelphia, PA
National Provider Identifier
1831656693
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN302047L
- Practice address
- 8220 Castor Ave
Philadelphia, PA 19152-2729 - Phone
- (267) 343-7130
- Fax
- (215) 745-6511
- NPI assigned
- Feb 27, 2019
- Sex
- Female
- Sole proprietor
- No
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 | RN302047L | PA | Primary |
Addresses
Primary practice location
8220 Castor Ave
Philadelphia, PA 19152-2729
Mailing address
8220 Castor Ave
Philadelphia, PA 19152-2729
Phone (267) 343-7130
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 |
|---|---|---|---|
| RN302047L | PA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1551225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551225600000",
"number": "1831656693",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8220 CASTOR AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191522729",
"telephone_number": "267-343-7130",
"fax_number": "215-745-6511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8220 CASTOR AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191522729",
"telephone_number": "267-343-7130",
"fax_number": "215-745-6511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERGKOETTER",
"first_name": "LISA",
"middle_name": "MARGUERITE",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-27",
"last_updated": "2019-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "PA",
"license": "RN302047L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.