Individual provider Active NPI

Lynn Marie Bergquist, M.D.

  • Internal Medicine Physician
  • Cincinnati, OH
National Provider Identifier
1982718706
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35078777 Issued in OH
Practice address
3200 Vine Street
Dept of Veterans Affairs Medical Center
Cincinnati, OH 45220-2447
Phone
(513) 861-3100
Fax
(513) 475-6528
NPI assigned
Aug 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35078777 OH Primary

Addresses

Primary practice location

3200 Vine Street
Dept of Veterans Affairs Medical Center
Cincinnati, OH 45220-2447

Mailing address

2980 Erie Ave
Cincinnati, OH 45208-2447
Phone (513) 861-3100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20130514000515 OH Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 8628084001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35078777OHMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982718706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2980 ERIE AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452082447",
            "telephone_number": "513-861-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 VINE STREET",
            "address_2": "DEPT OF VETERANS AFFAIRS MEDICAL CENTER",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452202447",
            "telephone_number": "513-861-3100",
            "fax_number": "513-475-6528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGQUIST",
        "first_name": "LYNN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35078777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.