KELLY MARIE BERGEN (NPI# 1093183642) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093183642 |
| Entity Type | Individual |
| Full Name | KELLY MARIE BERGEN |
| Other Name | KELLY MARIE NAVARRE |
| Credential | NP |
| Practice Address |
2555 Court Dr Suite 300 Gastonia NC 28054-2134 |
| Practice Telephone | 7048683256 |
| Practice Fax Number | 7048685870 |
| Mailing Telephone | 7048683256 |
| Mailing Fax Number | 7048685870 |
| Enumeration Date | 2015-09-11 |
| Last Update Date | 2015-09-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
162782 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
162782 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2555 COURT DR SUITE 300 |
| City | GASTONIA |
| State | NC |
| Zip Code | 28054-2134 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114925419 | Costa Andreou | Internal Medicine | 2555 Court Dr, Suite 300, Gastonia, NC 28054-2134 | 2005-07-11 |
| 1518411982 | Courtney Anne Manion | Physician Assistant | 2555 Court Dr, Suite 300, Gastonia, NC 28054-2134 | 2016-08-15 |
| 1457703837 | Zachary Yates Eaker | Physician Assistant | 2555 Court Dr, Suite #460, Gastonia, NC 28054-2134 | 2016-07-08 |
| 1114375300 | Treneice London | Nurse Practitioner | 2555 Court Dr, Suite 300, Gastonia, NC 28054-2179 | 2016-05-27 |
| 1578933826 | Emily Self | Physician Assistant | 2555 Court Dr, Suite 270, Gastonia, NC 28054-2134 | 2015-09-30 |
| 1023400249 | Adnan Ekram | Family Medicine | 2555 Court Dr, Suite 270, Gastonia, NC 28054-2134 | 2015-02-25 |
| 1760872006 | Danielle Jessen Howell | Physician Assistant | 2555 Court Dr, Suite 400, Gastonia, NC 28054-2134 | 2015-01-26 |
| 1275936502 | Shiddhi P Patel | Family Medicine | 2555 Court Dr, Suite 270, Gastonia, NC 28054-2134 | 2014-10-01 |
| 1346675501 | Kelly Davis Harris | Nurse Practitioner | 2555 Court Dr, Gastonia, NC 28054-2134 | 2013-09-06 |
| 1447500061 | Michael Joseph Miller | Internal Medicine | 2555 Court Dr, Suite 270, Gastonia, NC 28054-2134 | 2012-09-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225671423 | Michaela Karsyn Morris | Behavioral Analyst | 2875 Court Dr. B, Gastonia, NC 28054 | 2019-10-21 |
| 1982263810 | Brenda Sue Fox | Occupational Therapist | Brian Center, 969 Cox Rd, Gastonia, NC 28054 | 2019-06-13 |
| 1174096911 | Carolinas Hometown Respiratory LLC | Durable Medical Equipment & Medical Supplies | 469 Hospital Drive, Suite B1, Gastonia, NC 28054 | 2019-01-04 |
| 1255801817 | Jarae Mcswain | Counselor | 1558 Union Road, Ste F, Gastonia, NC 28054 | 2018-11-27 |
| 1427549807 | Alterman & Dhillon Charlotte Metro, Pplc | Dentist | 2205 E. Franklin Blvd, Ste 110, Gastonia, NC 28054 | 2018-05-22 |
| 1871083147 | Terrence Lamont Campbell | Dentist | 2641 Court Dr Ste A, Gastonia, NC 28054 | 2018-05-13 |
| 1861995367 | Jefferson and Jefferson LLC. | Respite Care | 945 East 6 Ave, Gastonia, NC 28054 | 2018-03-12 |
| 1790154912 | Tyler Adcock | Pharmacist | 2324 South New Hope Rd, Gastonia, NC 28054 | 2015-09-17 |
| 1922481894 | Alesha Nicole Logan | Nurse Practitioner | 1895 Hoffman Rd Ste A, Gastonia, NC 28054 | 2015-07-09 |
| 1457732596 | Buffie Baker Eller | Counselor | 2005 Flint Lane, Gastonia, NC 28054 | 2015-06-15 |
| Find all providers in zip 28054 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407488380 | Holly Murphy Ritger | Nurse Practitioner | 2544 Court Dr Ste D, Gastonia, NC 28054-3478 | 2020-02-07 |
| 1952933848 | Stephanie Diane Munoz | Nurse Practitioner | 2544 Court Dr Ste G, Gastonia, NC 28054-3450 | 2020-02-07 |
| 1427575638 | Joshua Quintin Crocker Osborne | Nurse Practitioner | 2544 Court Dr Ste D, Gastonia, NC 28054-3478 | 2017-08-28 |
| 1871965988 | Tina Nixon Ballard | Nurse Practitioner | 811 Cox Rd, Gastonia, NC 28054-3453 | 2015-10-28 |
| 1205232337 | Emily Barker Stallard | Nurse Practitioner | 1021 X Ray Dr, Gastonia, NC 28054-7489 | 2014-11-18 |
| 1346675501 | Kelly Davis Harris | Nurse Practitioner | 2555 Court Dr, Gastonia, NC 28054-2134 | 2013-09-06 |
| 1326390311 | Megan Hodge Wilkinson | Nurse Practitioner | 2555 Court Drive, Suite 400, Gastonia, NC 28054-2180 | 2012-10-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316544927 | Christine Marie Davis | Nurse Practitioner | 1010 Kenilworth Ave Apt 426, Charlotte, NC 28204-3475 | 2020-10-06 |
| 1447867700 | Ryan Richard Plesher | Nurse Practitioner | 10 Duke Medicine Cir Fl 8, Durham, NC 27710-1000 | 2020-09-29 |
| 1538774922 | Kathryn Rose Keurian | Nurse Practitioner | 10 Duke Medicine Cir # 3677, Durham, NC 27710-1000 | 2020-09-11 |
| 1669087243 | Linaleea Lopez | Nurse Practitioner | 108 Long Needle Dr, Clayton, NC 27520-8536 | 2020-09-10 |
| 1932713112 | Jessica H Resnyk | Nurse Practitioner | 2004 Cindy Ln, Clayton, NC 27520-9038 | 2020-09-03 |
| 1831702612 | Christopher Ireland | Nurse Practitioner | 4545 Long Cove Dr, Denver, NC 28037-5437 | 2020-08-31 |
| 1740893437 | Carlitha Saunders | Nurse Practitioner | 200 Medical Park Dr Ste 230, Concord, NC 28025-0933 | 2020-08-24 |
| 1508484031 | Stacey C Bohm | Nurse Practitioner | 15720 Brixham Hill Ave Ste 130, Charlotte, NC 28277-4784 | 2020-07-10 |
| 1750903969 | Lauren Brooke Kirby | Nurse Practitioner | 620 Moye Blvd, Greenville, NC 27834-0001 | 2020-05-11 |
| 1275154999 | Meghan Thompson Twisdale | Nurse Practitioner | 10 Duke Medicine Circle Duke Surgical Care Unit, Durham, NC 27710-0001 | 2020-05-05 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on KELLY MARIE BERGEN.
| 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.