DR. PHYLLIS ANN BERGERON (NPI# 1407990120) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407990120 |
| Entity Type | Individual |
| Full Name | DR. PHYLLIS ANN BERGERON |
| Credential | M.D. |
| Practice Address |
1375 E 19th Ave Denver CO 80218-1114 |
| Mailing Address |
3069 Fox Sedge Pl Highlands Ranch CO 80126-7595 |
| Practice Telephone | 3038123600 |
| Practice Fax Number | 3038124223 |
| Mailing Telephone | 3032637035 |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2020-02-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YX0007X |
Otolaryngology Specialization: Plastic Surgery within the Head & Neck |
30486 | CO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 01304864 | 05 | |
| CO | KAISER-COMMERCIAL NUMBER | 006041 | 01 |
| Street Address |
1375 E 19TH AVE |
| City | DENVER |
| State | CO |
| Zip Code | 80218-1114 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417946021 | Saint Joseph Hospital, Inc | General Acute Care Hospital | 1375 E 19th Ave, Denver, CO 80218-1114 | 2005-10-17 |
| 1588278519 | Scl Health Medical Group - Denver, LLC | Internal Medicine | 1375 E 19th Ave, Denver, CO 80218-1114 | 2020-09-08 |
| 1275147407 | Healthone Clinic Services - Orthopedic Specialists LLC | Orthopaedic Surgery | 1375 E 19th Ave, Denver, CO 80218-1114 | 2020-09-04 |
| 1306458310 | Healthone Clinic Services-surgical Specialties LLC | Surgery | 1375 E 19th Ave, Denver, CO 80218-1114 | 2020-08-20 |
| 1497373856 | Elizabeth Ann Simmons | Nurse Practitioner | 1375 E 19th Ave, Denver, CO 80218-1114 | 2020-07-11 |
| 1285251801 | Diana Monica Babumba-migadde | Registered Nurse | 1375 E 19th Ave, Denver, CO 80218-1114 | 2020-06-30 |
| 1033735113 | Healthone Clinic Services - Obstetrics and Gynecology LLC | Obstetrics & Gynecology | 1375 E 19th Ave, Denver, CO 80218-1114 | 2020-06-24 |
| 1871117051 | Obstetrix Medical Group of Colorado, P.C. | Pediatrics | 1375 E 19th Ave, Denver, CO 80218-1114 | 2020-06-03 |
| 1215558176 | Daniel Rutkowski | Physical Therapist | 1375 E 19th Ave, Denver, CO 80218-1114 | 2020-05-01 |
| 1457980773 | Rebekah Lee Mclaughlin | Registered Nurse | 1375 E 19th Ave, Denver, CO 80218-1114 | 2020-04-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598394462 | Robert Collins Taylor | Student in an Organized Health Care Education/Training Program | Family Medicine - Rainer General Surgery, 1960 Ogden Street, Suite 400, Denver, CO 80218 | 2020-04-03 |
| 1679136568 | Ayal Levi | Student in an Organized Health Care Education/Training Program | 1375 E. 19th Avenue Saint Joseph Hospital, Russell Pavillion, 2nd Floor Gme, Denver, CO 80218 | 2019-04-17 |
| 1588124408 | Leah Kellogg | Student in an Organized Health Care Education/Training Program | Bruner Family Medicine - 1960 Ogden St, Suite 460, Denver, CO 80218 | 2019-03-25 |
| 1316407828 | Brant Barry Hafen | Student in an Organized Health Care Education/Training Program | Family Medicine - Caritas Clinic, 1960 Ogden St., Suite 400, Denver, CO 80218 | 2019-03-21 |
| 1679058671 | Katarina Baldovin | Behavioral Analyst | 1430 Humboldt St, Apt 502, Denver, CO 80218 | 2018-09-26 |
| 1235677345 | Angelica Hollins Cunningham | Physical Therapist | 1830 N Franklin St Ste 400, Denver, CO 80218 | 2017-02-09 |
| 1104373786 | Anoush Simonyan | Counselor | 1724 Gilpin Street, Denver, CO 80218 | 2016-09-01 |
| 1881140143 | James Cole Abrams, LLC | Community/Behavioral Health | 1252 Corona St, Apt 4, Denver, CO 80218 | 2016-08-28 |
| 1316398167 | Joanna Ford Counseling | Community/Behavioral Health | 825 East Speer Blvd., 100b, Denver, CO 80218 | 2016-06-23 |
| 1487002671 | Anne Elizabeth Gulick | Physician Assistant | 1601 E 19th Ave, Suite 6600, Denver, CO 80218 | 2016-05-27 |
| Find all providers in zip 80218 | ||||
| Taxonomy Code | 207YX0007X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Plastic Surgery within the Head & Neck |
| An otolaryngologist with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgeries are practiced, there are many additional procedures which interface with them. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy is currently provided in the subspecialty of Otolaryngology/Facial Plastic Surgery (see Taxonomy Code 207YX0905X) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023451176 | Kelly Joy Pettijohn | Otolaryngology | 2045 N Franklin St, Denver, CO 80205 | 2013-04-08 |
| 1457502940 | Khalid Chowdhury Md, PC | Otolaryngology | 1601 E 19th Ave, Suite 3000, Denver, CO 80218-1216 | 2008-10-02 |
| 1295898187 | Ryan Andrew Gaines | Otolaryngology | 2555 S Downing St, Suite #100, Denver, CO 80210-5855 | 2006-12-19 |
| 1659473874 | Paul Harold Dragul | Otolaryngology | 850 E Harvard Ave, Ste #505, Denver, CO 80210-5073 | 2006-09-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902069545 | Michele Angelec Streeter | Otolaryngology | 1339 Phay Ave, Canon City, CO 81212-2301 | 2008-07-03 |
| 1174834972 | David Joseph Grindler | Otolaryngology | 10240 Park Meadows Dr, Lone Tree, CO 80124-5425 | 2010-06-25 |
| 1952445587 | Lawrence A Gordon | Otolaryngology | 10240 Park Meadows Dr, Lone Tree, CO 80124-5425 | 2007-02-16 |
| 1235218009 | Healthone Clinic Services LLC | Otolaryngology | 799 E Hampden Ave, Suite 530, Englewood, CO 80113-2786 | 2006-11-03 |
| 1053490839 | Andrew J Nemechek | Otolaryngology | 701 E Hampden Ave Ste 225, Englewood, CO 80113-2737 | 2006-11-03 |
| 1376560375 | Seth A Reiner, M.d., P.C. | Otolaryngology | 200 W County Line Rd, Suite 330, Highlands Ranch, CO 80129-2360 | 2006-07-16 |
| 1770522302 | Seth Allen Reiner | Otolaryngology | 200 W County Line Rd, Suite 330, Highlands Ranch, CO 80129-2360 | 2006-06-06 |
| 1508805045 | Henry Patrick Carr | Otolaryngology | 10099 Ridgegate Pkwy, Suite 230, Lone Tree, CO 80124-5531 | 2006-06-06 |
| 1285606764 | Frederic White-brown Deleyiannis | Otolaryngology | 13123 E 16th Ave, Aurora, CO 80045-7106 | 2006-02-07 |
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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.