JORDAN LEIGH BERGSTROM (NPI# 1750941779) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750941779 |
| Entity Type | Individual |
| Full Name | JORDAN LEIGH BERGSTROM |
| Other Name | JORDAN LEIGH HOFFMAN |
| Credential | AU.D. |
| Practice Address |
1753 Fulton St Elkhart IN 46514-1927 |
| Mailing Address |
710 N Niles Ave South Bend IN 46617-1924 |
| Practice Telephone | 5742939448 |
| Mailing Telephone | 5746471610 |
| Mailing Fax Number | 5742376069 |
| Enumeration Date | 2019-06-20 |
| Last Update Date | 2019-10-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 231H00000X | Audiologist | 23002688A | IN | Speech, Language and Hearing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 300027641 | 05 |
| Street Address |
1753 FULTON ST |
| City | ELKHART |
| State | IN |
| Zip Code | 46514-1927 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215936737 | James R Miller | General Practice | 1753 Fulton St, Elkhart, IN 46514-1927 | 2005-07-18 |
| 1295087500 | Beacon Medical Group, Inc. | Otolaryngology | 1753 Fulton St, Elkhart, IN 46514-1927 | 2012-10-10 |
| 1831321942 | Diego Heredia Vintimilla | Internal Medicine | 1753 Fulton St, Elkhart, IN 46514-1927 | 2009-08-24 |
| 1275735581 | John S Gilbert | Otolaryngology | 1753 Fulton St, Elkhart, IN 46514-1927 | 2007-05-31 |
| 1376607028 | Amberly L Burger | Internal Medicine | 1753 Fulton St, Elkhart, IN 46514-1927 | 2006-12-20 |
| 1508950122 | Eliud Irizarry Claudio | Psychiatry & Neurology | 1753 Fulton St, Suite A, Elkhart, IN 46514-1927 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891333522 | Adam Collier | Nurse Anesthetist, Certified Registered | 600 Elkhart Boulvard, Elkhart, IN 46514 | 2019-12-12 |
| 1861034688 | Heart City Health Center, Inc. | Obstetrics & Gynecology | 1545 Cassopolis Street, Elkhart, IN 46514 | 2019-10-14 |
| 1982263398 | Fresenius Medical Care North Elkhart, LLC | Clinic/Center | 801 W Bristol St, Elkhart, IN 46514 | 2019-06-10 |
| 1487118220 | Hellenic Senior Living of Elkhart, LLC | Assisted Living Facility | 2528 Bypass Road, Elkhart, IN 46514 | 2019-01-25 |
| 1922595792 | Anna Cornelia Smith | Nutritionist | 51803 Tall Pines Dr, Elkhart, IN 46514 | 2018-04-17 |
| 1114438496 | Erika Lynn Farrell | Counselor | 3120 Suite B Windsor Court, Elkhart, IN 46514 | 2017-10-13 |
| 1740728948 | Michael Scheretie | Nurse Anesthetist, Certified Registered | 52866 Wildflower Ln, Elkhart, IN 46514 | 2017-02-08 |
| 1821355876 | Marcy Lynn Adams | Nurse Practitioner | 1104 W Bristol St, Elkhart, IN 46514 | 2012-04-16 |
| 1053694265 | Paul A. Price | Pharmacist | 1400 Cassopolis St., Elkhart, IN 46514 | 2011-09-23 |
| 1528362647 | Beacon Medical Group, Inc. | Internal Medicine | 500 Arcade Ave., Suite 400, Elkhart, IN 46514 | 2011-01-04 |
| Find all providers in zip 46514 | ||||
| Taxonomy Code | 231H00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Audiologist |
| (1) A specialist in evaluation, habilitation and rehabilitation of those whose communication disorders center in whole or in part in hearing function. Audiologists are autonomous professionals who identify, assess, and manage disorders of the auditory, balance and other neural systems. Audiologists provide audiological (aural) rehabilitation to children and adults across the entire age span. Audiologists select, fit and dispense amplification systems such as hearing aids and related devices. (2) An audiologist is a person qualified by a master’s degree in audiology, licensed by the state, where applicable, and practicing within the scope of that license. Audiologists evaluate and treat patients with impaired hearing. They plan, direct and conduct rehabilitative programs with audiotry substitutional devises (hearing aids) and other therapy. |
| Notes: Source: (1) American Speech-Language-Hearing Association, (1996, Spring) Scope of practice in Audiology, p. 2 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912458019 | Chelsea Twyman | Audiologist | Beacon Medical Group Specialists, 1753 Fulton Street, Elkhart, IN 46514-1927 | 2016-10-24 |
| 1194078634 | Abigail Anne Johnson | Audiologist | 303 S Nappanee St, Elkhart, IN 46514-2066 | 2012-10-22 |
| 1962676106 | Patricia Welty | Audiologist | 1755 Fulton St, Suite A, Elkhart, IN 46514-1927 | 2008-04-18 |
| 1528063773 | Karen L. Zigon | Audiologist | 303 S Nappanee St, Elkhart, IN 46514-2066 | 2005-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053922187 | Ryan David Leahy | Audiologist | 480 W Navajo St Ste A, West Lafayette, IN 47906-1940 | 2020-08-12 |
| 1720698558 | Shelby Zimmerman | Audiologist | 11725 Illinois St Ste 447, Carmel, IN 46032-3010 | 2020-08-06 |
| 1902441868 | Carolyn Herbert | Audiologist | 8330 Naab Rd Ste 235, Indianapolis, IN 46260-1932 | 2019-11-14 |
| 1518517002 | Katherine Noelle Griffith | Audiologist | 2421 Plum Woods Dr, Sellersburg, IN 47172-9081 | 2019-09-17 |
| 1548818131 | Allison Kern | Audiologist | 9106 N Meridian St Ste 200, Indianapolis, IN 46260-1826 | 2019-08-28 |
| 1508419359 | Barbara L Martig | Audiologist | 8425 Woodfield Crossing Blvd Ste 100, Indianapolis, IN 46240-7316 | 2019-07-22 |
| 1184286783 | Emily Elyse Brennecke | Audiologist | 1115 Ronald Reagan Pkwy Ste 255, Avon, IN 46123-6913 | 2019-07-03 |
| 1952961591 | Sarah Jewel Gurnik | Audiologist | 2020 S State Road 135 Ste 200, Greenwood, IN 46143-6503 | 2019-06-17 |
| 1942869292 | Elizabeth Zuber | Audiologist | 9604 Coldwater Rd Ste 103, Fort Wayne, IN 46825-2096 | 2019-06-11 |
| 1225696875 | Angela Pollack | Audiologist | 201 N Illinois St Fl 16, Indianapolis, IN 46204-1904 | 2019-05-30 |
| Find all providers with the same taxonomy | ||||
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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.