NICOLE MARIE BERGMAN PA-C NPI 1639468184

NPI Information

NPI: 1639468184
Provider Name: NICOLE MARIE BERGMAN, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
702 COMMERCE DR
SUITE 100
PERRYSBURG, OH
ZIP 43551
Phone: (419) 872-4673
Get Directions

Nicole Marie Bergman, PA-C is a medical physician assistant in Perrysburg, OH. Nicole Marie Bergman, PA-C NPI is 1639468184. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

702 COMMERCE DR
SUITE 100
PERRYSBURG, OH
ZIP 43551-239
Phone: (419) 872-4673
Fax: (419) 873-8329

The NPI 1639468184 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/5/2011 and was last updated on 11/7/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	50.003246	OHIO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	9344881	OTHER	OHIO	MEDICARE GROUP
2	H065730	MEDICARE PIN	OHIO
3	DD1846	OTHER	OHIO	RAILROAD MEDICARE GROUP

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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