Tammy Thompson Bergeon, PT ATC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501008750 Issued in MI

Practice address

4812 Foster Rd
Midland, MI 48642-3230

Phone

(989) 430-7187

NPI assigned

Mar 11, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Evergreen Physical Therapy Limited Partnership

  • Physical Therapist
  • Bay City, MI
  • NPI 1154647659
  NPD (past)
• Thibodeau Physical Therapy Limited Partnership

  • Physical Therapy Clinic/Center
  • Lapeer, MI
  • NPI 1508943853

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1142035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1861460107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4812 FOSTER RD",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486423230",
            "telephone_number": "989-430-7187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4812 FOSTER RD",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486423230",
            "telephone_number": "989-430-7187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGEON",
        "first_name": "TAMMY",
        "middle_name": "THOMPSON",
        "name_prefix": "Ms.",
        "credential": "PT ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-11",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501008750",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF COMM HEALTH",
            "identifier": "5501008750",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "650E611120",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "650E610810",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Orest John Berezecky, DO
• Bridgett Berg
• George Berg, PT, DPT
• Paul D Berg, MD
• Blake A Bergeon, MD
• Nathaniel Bergman
• Fredric James Bergstein, RPH
• Timothy Berka, MD
• Lorenzo D Berlanga, M.D.
• Cheryl A Berry, LMSW

• All providers in Midland, MI
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2020; 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.