Individual provider Active NPI

Jenna Ruth Ember Bergerson, M.D.

  • Allergy & Immunology Physician
  • Bethesda, MD
National Provider Identifier
1851682249
Registry record updated Dec 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
036135230 Issued in IL
Practice address
9000 Rockville Pike BLDG 10
Bethesda, MD 20892
Phone
(301) 761-6276
NPI assigned
Apr 20, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 036135230 IL Primary

Addresses

Primary practice location

9000 Rockville Pike BLDG 10
Bethesda, MD 20892

Mailing address

9000 Rockville Pike BLDG 10
Bethesda, MD 20892-0001
Phone (301) 761-6276

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.nih.gov

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036135230ILMDAllergy & Immunology Physician

NPI Registry JSON

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

{
    "created_epoch": "1303257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701475200000",
    "number": "1851682249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 ROCKVILLE PIKE BLDG 10",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208920001",
            "telephone_number": "301-761-6276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 ROCKVILLE PIKE BLDG 10",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "20892",
            "telephone_number": "301-761-6276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGERSON",
        "first_name": "JENNA",
        "middle_name": "RUTH EMBER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-20",
        "last_updated": "2023-12-02",
        "certification_date": "2023-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "IL",
            "license": "036135230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.nih.gov",
            "affiliation": "N",
            "address_1": "9000 Rockville Pike Bldg 10",
            "city": "Bethesda",
            "state": "MD",
            "country_code": "US",
            "postal_code": "20892",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.