Active NPI
Jennifer Leigh Bergeron, P.T.
- Physical Therapist
- Brighton, MA
National Provider Identifier
1881880235
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 17967
- Practice address
- 55 Shannon St
Apt #1
Brighton, MA 02135-3408 - Phone
- (902) 310-9242
- NPI assigned
- Sep 19, 2007
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 17967 | MA | Primary |
Addresses
Primary practice location
55 Shannon St
Apt #1
Brighton, MA 02135-3408
Mailing address
55 Shannon St
Apt #1
Brighton, MA 02135-3408
Phone (902) 310-9242
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17967 | MA | MD | Pharmacist |
| 3464 | NH | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190160000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190160000000",
"number": "1881880235",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 SHANNON ST",
"address_2": "APT #1",
"city": "BRIGHTON",
"state": "MA",
"postal_code": "021353408",
"telephone_number": "902-310-9242"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 SHANNON ST",
"address_2": "APT #1",
"city": "BRIGHTON",
"state": "MA",
"postal_code": "021353408",
"telephone_number": "902-310-9242"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERGERON",
"first_name": "JENNIFER",
"middle_name": "LEIGH",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-19",
"last_updated": "2007-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "17967",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brighton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.