DR. MARVIN BERGESON (NPI# 1083689590) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083689590 |
| Entity Type | Individual |
| Full Name | DR. MARVIN BERGESON |
| Credential | M.D. |
| Practice Address |
1001 Noble St Fairbanks AK 99701-4922 |
| Practice Telephone | 9074593520 |
| Practice Fax Number | 9074593526 |
| Mailing Telephone | 9074593500 |
| Mailing Fax Number | 9074593526 |
| Enumeration Date | 2006-02-18 |
| Last Update Date | 2016-09-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 1824 | AK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DEA NUMBER | AB1821479 | 01 | |
| AK | 1010782 | 05 |
| Street Address |
1001 NOBLE ST |
| City | FAIRBANKS |
| State | AK |
| Zip Code | 99701-4922 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245239524 | David Kent Zetterman | Family Medicine | 1001 Noble St, Fairbanks, AK 99701-4922 | 2005-07-19 |
| 1811501679 | Professional Pharmacy LLC | Pharmacy | 1001 Noble St, Fairbanks, AK 99701-4948 | 2020-08-31 |
| 1942862149 | Jaime Nicole Sawchuk | Counselor | 1001 Noble St, Fairbanks, AK 99701-4948 | 2019-07-08 |
| 1154821593 | Shelby A Braun | Dietitian, Registered | 1001 Noble St, Fairbanks, AK 99701-4948 | 2018-02-12 |
| 1417492463 | Nancy Davidian | Registered Nurse | 1001 Noble St, Fairbanks, AK 99701-4948 | 2016-12-29 |
| 1437691771 | Katie Garrity | Dietitian, Registered | 1001 Noble St, Suite 450, Fairbanks, AK 99701-4948 | 2016-11-16 |
| 1922559558 | Tanana Valley Clinic LLC | Clinic/Center | 1001 Noble St, Fairbanks, AK 99701-4948 | 2016-10-19 |
| 1801240221 | Heather Powers | Dietitian, Registered | 1001 Noble St, Fairbanks, AK 99701-4948 | 2016-04-21 |
| 1023492642 | Jennifer Ribar | Neuromusculoskeletal Medicine & OMM | 1001 Noble St, Fairbanks, AK 99701-4948 | 2015-07-14 |
| 1013399708 | Rebekah L. Burket | Counselor | 1001 Noble St, Fairbanks, AK 99701-4948 | 2015-06-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659984987 | Resource Center for Parents & Children, Inc. | Social Worker | 726 26th Ave, Suite #2, Fairbanks, AK 99701 | 2020-08-26 |
| 1134738982 | Aaron Paul Sarauer | Behavior Technician | 3121 Lathrop St., Fairbanks, AK 99701 | 2020-07-28 |
| 1437715505 | Fabienne Rose Marie Siddall | Case Manager/Care Coordinator | 122 1st Avenue, Fairbanks, AK 99701 | 2019-05-14 |
| 1902461957 | Jacqueline Marie Rahm | Counselor | Family Centered Services of Alaska - Rtc, 3101 Lathrop St., Fairbanks, AK 99701 | 2019-05-06 |
| 1821588989 | Corrie Wilson | Nurse Practitioner | 1025 Barnette Street, Fairbanks, AK 99701 | 2018-05-15 |
| 1922519305 | Sarishma Sangeeta Lal | Registered Nurse | 815 2nd Ave Ste 122, Fairbanks, AK 99701 | 2017-10-12 |
| 1245690569 | Christine L Simko | Naturopath | 1275 Sadler Way, Ste 100 Rm 147, Fairbanks, AK 99701 | 2016-02-29 |
| 1932581600 | Jennifer Davis | Registered Nurse | 1025 West Barnette St., Fairbanks, AK 99701 | 2015-06-18 |
| 1700272705 | John D. Zipperer Jr Md, LLC | Clinic/Center | 751 Old Richardson Hwy., Fairbanks, AK 99701 | 2015-04-07 |
| 1578957460 | Mara Justine Becker | Physician Assistant | 1717 W. Cowles St, Fairbanks, AK- ALASKA 99701 | 2015-03-27 |
| Find all providers in zip 99701 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679644108 | Steven J Jay | Pediatrics | 3875 Geist Rd Ste E, Box 353, Fairbanks, AK 99709-3564 | 2006-11-13 |
| 1730278219 | Harry James Jordan | Pediatrics | 1008 16th Avenue, Suite 100 H James Jordan Md, Fairbanks, AK 99701 | 2006-10-12 |
| 1699774299 | Letha C Archer | Pediatrics | 1919 Lathrop St, Suite 100, Fairbanks, AK 99701-5937 | 2005-07-18 |
| 1518312453 | Carla Michelle Cartagena De Jesus | Pediatrics | 1001 Noble St Ste 1, Fairbanks, AK 99701-4991 | 2016-04-28 |
| 1750709978 | Gwendolyn Z Lieb | Pediatrics | 1717 W Cowles St, Fairbanks, AK 99701-5926 | 2014-04-04 |
| 1841556602 | Anne Rutherford Hanley | Pediatrics | 1001 Noble St, Fairbanks, AK 99701-4948 | 2012-04-05 |
| 1598081606 | Celina Marie Clift | Pediatrics | 1001 Noble St, Fairbanks, AK 99701-4922 | 2010-04-14 |
| 1437271871 | Manal Shihadeh | Pediatrics | 1919 Lathrop St, Suite100, Fairbanks, AK 99701-5930 | 2007-04-05 |
| 1417075177 | John Matthew De Pasquale | Pediatrics | 1001 Noble St, Fairbanks, AK 99701-4922 | 2007-03-27 |
| 1184770778 | Laura Brunner | Pediatrics | 1001 Noble St, Fairbanks, AK 99701-4922 | 2007-01-26 |
| Find all providers in FAIRBANKS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.