Individual provider Active NPI

Brooke Nicole Bergmann, PHARM.D.

  • Ambulatory Care Pharmacist
  • Daytona Beach, FL
National Provider Identifier
1922263243
Registry record updated Jul 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Care PharmacistTaxonomy code 1835P2201X
License
6151414 Issued in FL
Practice address
551 National Health Care Dr
Daytona Beach, FL 32114
Phone
(386) 323-7500
Fax
(386) 323-7503
NPI assigned
Jul 25, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X CACP #:0830-OLC-0314 FL
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X PS43663 FL
Ambulatory Care Pharmacist 1835P2201X 6151414 FL Primary

Addresses

Primary practice location

551 National Health Care Dr
Daytona Beach, FL 32114

Mailing address

551 National Health Care Dr
Daytona Beach, FL 32114-1495
Phone (386) 323-7500

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 Pharmacy

State licenses

LicenseStateTypeSpecialty
CACP #:0830-OLC-0314FLMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
PS43663FLMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
6151414FLMDAmbulatory Care Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1216944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530835200000",
    "number": "1922263243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "551 NATIONAL HEALTH CARE DR",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321141495",
            "telephone_number": "386-323-7500",
            "fax_number": "386-323-7503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551 NATIONAL HEALTH CARE DR",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "32114",
            "telephone_number": "386-323-7500",
            "fax_number": "386-323-7503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGMANN",
        "first_name": "BROOKE",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-25",
        "last_updated": "2018-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "FL",
            "license": "CACP #:0830-OLC-0314",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "FL",
            "license": "PS43663",
            "primary": false
        },
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "FL",
            "license": "6151414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2018; 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.