Active NPI
Bethany M Bergen
- Occupational Therapist
- Romney, WV
National Provider Identifier
1831823178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 1643
- Practice address
- 25072 Northwestern Pike
Romney, WV 26757-5039 - Phone
- (304) 822-2177
- NPI assigned
- Jul 12, 2022
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 1643 | WV | Primary |
Addresses
Primary practice location
25072 Northwestern Pike
Romney, WV 26757-5039
Mailing address
25072 Northwestern Pike
Romney, WV 26757-5039
Phone (304) 822-2177
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1643 | WV | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northern WV Home Health, LLC | Past | Accepting new patients | |
| Northern WV Home Health, LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Home Health Agency
- Romney, WV
- NPI 1861443210
-
- Home Health Agency
- Romney, WV
- NPI 1871544213
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657584000000",
"number": "1831823178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25072 NORTHWESTERN PIKE",
"city": "ROMNEY",
"state": "WV",
"postal_code": "267575039",
"telephone_number": "304-822-2177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25072 NORTHWESTERN PIKE",
"city": "ROMNEY",
"state": "WV",
"postal_code": "267575039",
"telephone_number": "304-822-2177"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERGEN",
"first_name": "BETHANY",
"middle_name": "M",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-12",
"last_updated": "2022-07-12",
"certification_date": "2022-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WV",
"license": "1643",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Romney, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.