Christen Troy Bergstrom

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

0000005364 Issued in TN

Practice address

851 Professional Park Dr
Clarksville, TN 37040

Phone

(931) 542-2168

Fax

(931) 542-2168

NPI assigned

Jan 8, 2008

Last updated

Jun 20, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kids Can DO, Inc.

  • Occupational Therapist
  • Mokena, IL
  • NPI 1861559585

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1199750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529452800000",
    "number": "1932384997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "851 PROFESSIONAL PARK DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370405257",
            "telephone_number": "931-542-2168",
            "fax_number": "931-542-2206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 PROFESSIONAL PARK DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "37040",
            "telephone_number": "931-542-2168",
            "fax_number": "931-542-2168"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19100 Crescent Dr",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "Mokena",
            "state": "IL",
            "postal_code": "604487501",
            "country_code": "US",
            "telephone_number": "708-478-5400",
            "fax_number": "708-478-5300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERGSTROM",
        "first_name": "CHRISTEN",
        "middle_name": "TROY",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-08",
        "last_updated": "2018-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "242.000739",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "0000005364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert R. Bendt, MD
• Monica Bennett
• Therese C Bennett, APRN
• Amy Benney
• De'Anna Benson, LMSW
• Shannan Leigh Berntson, LCSW
• Paul Michael Berrigan, PTA
• Sooji Berthiaume
• Alison Besaka
• Best Care Clinic PLC

• Speech-Language Pathologist in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Speech-Language Pathologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.