Carl Johan Christian Bergman, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

0101260033 Issued in VA

Practice address

2116 W Laburnum Ave
Richmond, VA 23227

Phone

(804) 254-3500

Fax

(804) 254-1616

NPI assigned

Mar 28, 2014

Last updated

Aug 29, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Christian Carl Bergman Other name

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Geriatric MedicineAlso: Internal Medicine

Education

University of Virginia School of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

MCV Associated PhysiciansGroup PAC ID 4385542117, 1,779 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Medical College of Virginia Hospitals Hospital, Richmond, VA, CCN 490032
• Southampton Rehabilitation and Healthcare Center Nursing home, Richmond, VA, CCN 495423
• Canterbury Rehabilitation and Healthcare Center Nursing home, Richmond, VA, CCN 495272
• Glenburnie Rehab & Nursing Center Nursing home, Richmond, VA, CCN 495391

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Southampton Operator, LLC

  dba Southampton Rehabilitation and Healthcare Center

  • Skilled Nursing Facility
  • Richmond, VA
  • NPI 1619697976

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

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.

• MCV Associated Physicians

  dba MCV Physicians

  • Anesthesiology Physician
  • Richmond, VA
  • NPI 1710959457
  Medicare reassignment Care Compare group NPD

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

• Canterbury Operator LLC

  dba Canterbury Rehabilitation and Healthcare Center

  • Skilled Nursing Facility
  • Richmond, VA
  • NPI 1811546955

  Nursing home

  Care Compare affiliation
• Glenburnie Operator LLC

  dba Glenburnie Rehabilitation and Nursing Center

  • Skilled Nursing Facility
  • Richmond, VA
  • NPI 1073154373

  Nursing home

  Care Compare affiliation
• Southampton Operator, LLC

  dba Southampton Rehabilitation and Healthcare Center

  • Skilled Nursing Facility
  • Richmond, VA
  • NPI 1619697976

  Nursing home

  Care Compare affiliation
• Virginia Commonwealth University Health System Authority

  dba Medical College of Virginia Hospitals

  • General Acute Care Hospital
  • Richmond, VA
  • NPI 1013091727
  Care Compare affiliation
• Virginia Commonwealth University Health System Authority

  dba VCU Medical Center

  • General Acute Care Hospital
  • Richmond, VA
  • NPI 1437175734
  Care Compare affiliation

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

{
    "created_epoch": "1395964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535500800000",
    "number": "1982021895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 91734",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232911734",
            "telephone_number": "804-358-6100",
            "fax_number": "804-342-7619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2116 W LABURNUM AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "23227",
            "telephone_number": "804-254-3500",
            "fax_number": "804-254-1616"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1250 E Marshall St",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232985051",
            "country_code": "US",
            "telephone_number": "804-254-3500",
            "fax_number": "804-254-1616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERGMAN",
        "first_name": "CARL",
        "middle_name": "JOHAN CHRISTIAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-28",
        "last_updated": "2018-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "VA",
            "license": "0101260033",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101260033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTIAN",
            "last_name": "BERGMAN",
            "middle_name": "CARL",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Caroline Elizabeth Benz, MD
• Katherine Bereznicki
• Phyllis Ann Berg, PH.D.
• Daniel Julius Berger
• Brett Redmond Bergin, CPO
• Jennifer Bergvall, OD
• Alem Berhane
• Jonathan David Berkman, M.D.
• Scott Berl
• Alice Joyce Berman, LPC

• Internal Medicine Physician in Richmond, VA
• Providers in Richmond, VA by specialty
• Internal Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.