Rose Bergquist, PA

Primary specialty

Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X

License

PAC0235 Issued in ND

Practice address

1000 Highway 12
Hettinger, ND 58639-7530

Phone

(701) 567-4561

Fax

(701) 567-6361

NPI assigned

Sep 25, 2006

Last updated

Feb 22, 2019By 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550793600000",
    "number": "1952401200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 HIGHWAY 12",
            "city": "HETTINGER",
            "state": "ND",
            "postal_code": "586397530",
            "telephone_number": "701-567-4561",
            "fax_number": "701-567-6361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HIGHWAY 12",
            "city": "HETTINGER",
            "state": "ND",
            "postal_code": "586397530",
            "telephone_number": "701-567-4561",
            "fax_number": "701-567-6361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGQUIST",
        "first_name": "ROSE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2019-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ND",
            "license": "PAC0235",
            "primary": false
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "ND",
            "license": "PAC0235",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF NORTH DAKOT",
            "identifier": "19144",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adams County Social Service Board
• Karen Wai-Kai Andres, MD
• Brandy Beckman
• Charle's Angels of Caring
• Lisa Clayton, ST
• Gary William Dewhirst, R.PH
• Dr Gabbert Clinical Psychologist PLLC
• William C Elder, M.D.

• Psychiatric/Mental Health Clinical Nurse Specialist in Hettinger, ND
• Providers in Hettinger, ND by specialty
• Psychiatric/Mental Health Clinical Nurse Specialist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2019; 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.