Individual provider Active NPI

Michael Morgan Bergman, A.R.N.P.

  • Family Nurse Practitioner
  • Shawnee, KS
National Provider Identifier
1952548307
Registry record updated Jun 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
46310 Issued in KS
Practice address
7405 Renner Rd # Podb
Shawnee, KS 66217-9414
Phone
(913) 588-8465
Fax
(913) 588-8529
NPI assigned
Jan 7, 2009
Last updated
Jun 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 46310 KS Primary

Addresses

Primary practice location

7405 Renner Rd # Podb
Shawnee, KS 66217-9414

Mailing address

7405 Renner Rd # Podb
Shawnee, KS 66217-9414
Phone (913) 588-8465

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100914000435 KS Practitioner - Nurse Practitioner 9931224086 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jayhawk Primary Care IncGroup PAC ID 8123928900, 157 clinicians

Practice addresses (Care Compare)

7405 Renner Rd
Shawnee, KS 66217-9414
Phone (913) 588-8400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jayhawk Primary Care Inc CurrentSince Jun 1, 2022 Accepting new patients
Jayhawk Primary Care Inc CurrentSince Jun 1, 2022 Accepting new patients
College Park Family Care Center PA Past Accepting new patients
Jayhawk Primary Care Inc Past Accepting new patients
Reverse Medical Services LLC PastSince May 25, 2014 Accepting new patients

Locations

20333 W 151st St
Olathe, KS 66061
Phone (888) 960-1393

7405 Renner Rd
Shawnee Msn, KS 66217
Phone (913) 588-2200

Organizations & group practices 5

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1231286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1952548307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7405 RENNER RD # PODB",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662179414",
            "telephone_number": "913-588-8465",
            "fax_number": "913-588-8529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7405 RENNER RD # PODB",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662179414",
            "telephone_number": "913-588-8465",
            "fax_number": "913-588-8529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGMAN",
        "first_name": "MICHAEL",
        "middle_name": "MORGAN",
        "credential": "A.R.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-07",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "46310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee, KS

Sources for this page

Verify at the official NPI Registry.