Active NPI
Michael Scott Bergman, CRNA
- Certified Registered Nurse Anesthetist
- Southaven, MS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 58180
- Practice address
- 7601 Southcrest Pkwy
Southaven, MS 38671-4739 - Phone
- (662) 349-4000
- NPI assigned
- Jul 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 11
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 1322 | WY | |
| Certified Registered Nurse Anesthetist | 367500000X | A810193 | MS | |
| Certified Registered Nurse Anesthetist | 367500000X | 273250-3120 | UT | |
| Certified Registered Nurse Anesthetist | 367500000X | 200860036 | OR | |
| Certified Registered Nurse Anesthetist | 367500000X | AP60225469 | WA | |
| Certified Registered Nurse Anesthetist | 367500000X | RNA-899 | ID | |
| Certified Registered Nurse Anesthetist | 367500000X | D161234 | IA | |
| Certified Registered Nurse Anesthetist | 367500000X | 43557575072 | KS | |
| Certified Registered Nurse Anesthetist | 367500000X | CRNA000533 | NV | |
| Certified Registered Nurse Anesthetist | 367500000X | APRN130636 | MT | |
| Certified Registered Nurse Anesthetist | 367500000X | 58180 | NM | Primary |
Addresses
Primary practice location
7601 Southcrest Pkwy
Southaven, MS 38671-4739
Mailing address
929 Fallen Oaks Dr
Collierville, TN 38017-3540
Phone (901) 853-2336
Other practice location 1
1400 Bellinger St
Eau Claire, WI 54703-5222
Phone (715) 838-5222
Other practice location 2
600 Mt Highway 91 S
Dillon, MT 59725-7379
Phone (406) 683-3000
Other names 1
- Michael Scott Bergman
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mbergman2858304@wm.providencedirect.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR, WA, NV, ND, WI, NM, WY, UT
Enrollment records 8
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D161234 | IA | MD | Certified Registered Nurse Anesthetist |
| RNA-899 | ID | MD | Certified Registered Nurse Anesthetist |
| 43557575072 | KS | MD | Certified Registered Nurse Anesthetist |
| APRN130636 | MT | MD | Certified Registered Nurse Anesthetist |
| 200860036 | OR | MD | Certified Registered Nurse Anesthetist |
| 273250-3120 | UT | MD | Certified Registered Nurse Anesthetist |
Practice roles
Locations
7360 Solutions Ctr
Chicago, IL 60677
Phone (701) 237-8033
200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850
900 E Broadway Ave
Bismarck, ND 58501
Phone (701) 530-7300
2500 Fairway St
Dickinson, ND 58601
Phone (701) 456-4000
3001 Broadmoor Blvd NE
Rio Rancho, NM 87144
Phone (505) 994-7000
117 E 19th St
Roswell, NM 88201
Phone (505) 727-2000
1600 Medical Pkwy
Carson City, NV 89703
Phone (775) 220-9149
2001 Errecart Blvd
Elko, NV 89801
Phone (775) 738-5151
610 NW 11th St
Hermiston, OR 97838
Phone (541) 667-3400
750 W 800 N
Orem, UT 84057
Phone (801) 714-6000
1954 E Fort Union Blvd
Ste 105
Salt Lake Cty, UT 84121
Phone (801) 993-9524
1105 Dale Ave
Benton City, WA 99320
Phone (509) 588-4075
888 Swift Blvd
Richland, WA 99352
Phone (509) 942-2115
733 W Clairemont Ave
Eau Claire, WI 54701
Phone (715) 838-3806
1400 Bellinger St
Eau Claire, WI 54703
Phone (715) 838-3311
150 E Arapahoe St
Thermopolis, WY 82443
Phone (307) 864-3121
Interoperability endpoints
- mbergman2858304@wm.providencedirect.org
Organizations & group practices 22
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Anesthesiology Physician
- Carson City, NV
- NPI 1063169829
Nurse Anesthetist, Certified Registered
-
dba Good Shepherd Medical Center
- Critical Access Hospital
- Hermiston, OR
- NPI 1295789667
-
- Critical Access Hospital
- Thermopolis, WY
- NPI 1861550642
-
- Anesthesiology Physician
- Albuquerque, NM
- NPI 1275010985
-
dba Mayo Clinic Health System in Eau Claire
- Multi-Specialty Clinic/Center
- Eau Claire, WI
- NPI 1235588831
-
- Anesthesiology Physician
- Orem, UT
- NPI 1043249840
-
dba Premier Anesthesia of Richland
- Anesthesiology Physician
- Richland, WA
- NPI 1013940253
Nurse Anesthetist, Certified Registered
-
dba Prosser Memorial Health
- Critical Access Hospital
- Prosser, WA
- NPI 1306897681
-
dba CHI St Alexius Health Dickinson Medical Clinic
- Clinic/Center
- Dickinson, ND
- NPI 1730464108
-
dba CHI St. Alexius Health Clinics
- Specialist
- Bismarck, ND
- NPI 1205868429
-
- Anesthesiology Physician
- Elko, NV
- NPI 1801450572
-
dba Whitman Hospital & Medical Center
- Critical Access Hospital
- Colfax, WA
- NPI 1922009448
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724198400000",
"number": "1972517977",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "929 FALLEN OAKS DR",
"city": "COLLIERVILLE",
"state": "TN",
"postal_code": "380173540",
"telephone_number": "901-853-2336"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7601 SOUTHCREST PKWY",
"city": "SOUTHAVEN",
"state": "MS",
"postal_code": "386714739",
"telephone_number": "662-349-4000"
}
],
"practiceLocations": [
{
"address_1": "1400 Bellinger St",
"address_purpose": "LOCATION",
"city": "Eau Claire",
"state": "WI",
"postal_code": "547035222",
"country_code": "US",
"telephone_number": "715-838-5222",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "600 Mt Highway 91 S",
"address_purpose": "LOCATION",
"city": "Dillon",
"state": "MT",
"postal_code": "597257379",
"country_code": "US",
"telephone_number": "406-683-3000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BERGMAN",
"first_name": "MICHAEL",
"middle_name": "SCOTT",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-28",
"last_updated": "2024-08-21",
"certification_date": "2024-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "WY",
"license": "1322",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MS",
"license": "A810193",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "UT",
"license": "273250-3120",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "OR",
"license": "200860036",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "WA",
"license": "AP60225469",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "ID",
"license": "RNA-899",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "IA",
"license": "D161234",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "KS",
"license": "43557575072",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "NV",
"license": "CRNA000533",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MT",
"license": "APRN130636",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "NM",
"license": "58180",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mbergman2858304@wm.providencedirect.org",
"affiliation": "N",
"address_1": "600 Mt Highway 91 S",
"city": "Dillon",
"state": "MT",
"country_code": "US",
"postal_code": "597257379",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "MICHAEL",
"last_name": "BERGMAN",
"middle_name": "SCOTT",
"credential": "CRNA",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Southaven, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.