Active NPI
Cameron Berghorst
- Pathology Specialist/Technologist
- Grand Rapids, MI
National Provider Identifier
1831980440
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pathology Specialist/Technologist
- License
- 7101009478
- Practice address
- 5258 Plainfield Ave NE
Grand Rapids, MI 49525-1092 - Phone
- (616) 719-0490
- NPI assigned
- May 14, 2025
- 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 |
|---|---|---|---|---|
| Pathology Specialist/Technologist | 246Q00000X | 7101009478 | MI | Primary |
Addresses
Primary practice location
5258 Plainfield Ave NE
Grand Rapids, MI 49525-1092
Mailing address
6834 Byron Lakes Dr SW Apt 1a
Byron Center, MI 49315-9772
Phone (630) 768-2179
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 |
|---|---|---|---|
| 7101009478 | MI | MD | Pathology Specialist/Technologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mitten State Pediatric Therapy LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Occupational Therapist
- Grand Rapids, MI
- NPI 1063021715
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1747180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1770854400000",
"number": "1831980440",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6834 BYRON LAKES DR SW APT 1A",
"city": "BYRON CENTER",
"state": "MI",
"postal_code": "493159772",
"telephone_number": "630-768-2179"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5258 PLAINFIELD AVE NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495251092",
"telephone_number": "616-719-0490"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERGHORST",
"first_name": "CAMERON",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-05-14",
"last_updated": "2026-02-12",
"certification_date": "2026-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "246Q00000X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Pathology",
"state": "MI",
"license": "7101009478",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.