DR. MICHAEL BERGEN (NPI# 1407116718) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407116718 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL BERGEN |
| Credential | MD |
| Practice Address |
1906 Belleview Ave Se Roanoke VA 24014-1838 |
| Practice Telephone | 5409817000 |
| Mailing Telephone | 5409817000 |
| Enumeration Date | 2012-05-21 |
| Last Update Date | 2019-10-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
0101267361 | VA | Allopathic & Osteopathic Physicians |
| N | 208D00000X | General Practice | 2756654 | NY | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | NY | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134786346 | Michael Adam Bergen | Orthopaedic Surgery | 593 Eddy St, Providence, RI 02903-4923 | 2019-05-22 |
| 1083639827 | Michael Howard Bergen | Specialist | 460 W 34th St, New York, NY 10001-2320 | 2006-07-13 |
| 1851385330 | Michael K Bergen | Internal Medicine | 600 S 5th St, Montrose, CO 81401-5711 | 2005-09-09 |
| Street Address |
1906 BELLEVIEW AVE SE |
| City | ROANOKE |
| State | VA |
| Zip Code | 24014-1838 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053315796 | Lee Ann Speed | Registered Nurse | 1906 Belleview Ave Se, Roanoke, VA 24014-1838 | 2005-06-10 |
| 1114526605 | Kimberly Ann Ramsey | Clinical Nurse Specialist | 1906 Belleview Ave Se, Roanoke, VA 24014-1838 | 2020-10-26 |
| 1578181285 | Sarah Lipps | Pharmacist | 1906 Belleview Ave Se, Roanoke, VA 24014-1838 | 2020-07-09 |
| 1124646831 | Shannon Victoria Brown | Pharmacist | 1906 Belleview Ave Se, Roanoke, VA 24014-1838 | 2020-07-09 |
| 1285252189 | Yang Zhao | Pharmacist | 1906 Belleview Ave Se, Roanoke, VA 24014-1838 | 2020-07-08 |
| 1932727831 | Jonathan Zalman | Pharmacist | 1906 Belleview Ave Se, Roanoke, VA 24014-1838 | 2020-07-08 |
| 1669090569 | Miranda Thomas | Pharmacist | 1906 Belleview Ave Se, Roanoke, VA 24014-1838 | 2020-07-08 |
| 1427676329 | Zachary Seth Stevenson | Pharmacist | 1906 Belleview Ave Se, Roanoke, VA 24014-1838 | 2020-07-08 |
| 1053939801 | Narmada Mannem | Student in an Organized Health Care Education/Training Program | 1906 Belleview Ave Se, Roanoke, VA 24014-1838 | 2020-07-08 |
| 1821616657 | Vanessa Pellegrino | Pharmacist | 1906 Belleview Ave Se, Roanoke, VA 24014-1838 | 2020-07-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417558602 | Irene Pace Seidman | Pharmacist | 3350 Clearbrook Village Ln, Roanoke, VA 24014 | 2020-11-04 |
| 1720617970 | Mounica Reddy Thootkur | Student in an Organized Health Care Education/Training Program | 2017 South Jefferson Street, 2nd Floor, Roanoke, VA 24014 | 2020-04-08 |
| 1326675422 | Bharath Muppala | Student in an Organized Health Care Education/Training Program | Carilion Roanoke Memorial Hospital, 1906 Belleview Ave, Roanoke, VA 24014 | 2020-03-26 |
| 1235629239 | Sanjeeb Sudarshan Bhandari | Student in an Organized Health Care Education/Training Program | 1906 Bellview Ave Se, Roanoke, VA 24014 | 2018-05-15 |
| 1104325778 | Vera J. Short | Registered Nurse | 3167 Huffman Ln, Roanoke, VA 24014 | 2018-02-08 |
| 1770001380 | Michael Alan Phillips I | Social Worker | 2017 Jefferson Street, Roanoke, VA 24014 | 2017-09-03 |
| 1306362884 | Sara Alicia Guasch | Student in an Organized Health Care Education/Training Program | Carilion Roanoke Memorial Hospital, 1906 Belleview Ave, Roanoke, VA 24014 | 2017-08-16 |
| 1790212256 | Pouya Mafi | Student in an Organized Health Care Education/Training Program | 1906 Belleview Ave, Carilion Roanoke Memorial Hospital, Roanoke, VA 24014 | 2017-05-16 |
| 1790222867 | Mara Cate | Physician Assistant | 523 Arbuttus Ave, Roanoke, VA 24014 | 2017-01-26 |
| 1508314634 | Dknl Enterprises, Inc. | Non-emergency Medical Transport (VAN) | 3629 Franklin Rd Sw Suite 205b, Roanoke, VA 24014 | 2016-09-19 |
| Find all providers in zip 24014 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| 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 Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508008913 | Louise Godine | Radiology | 2840 Electric Rd, Suite 205 A, Roanoke, VA 24018-3551 | 2009-03-31 |
| 1073750816 | Roanoke Imaging LLC | Radiology | 4330 Brambleton Ave, Roanoke, VA 24018-3405 | 2009-01-15 |
| 1063467082 | Oddyssey Iv, LLC | Radiology | 2923 Franklin Rd Sw, Roanoke, VA 24014-1001 | 2006-05-24 |
| 1992768147 | Naiyer Imam | Radiology | 7636 Williamson Rd, Roanoke, VA 24019-4341 | 2006-04-10 |
| 1437111598 | Sutin - Srisumrid | Radiology | 3703 Sunridge Ln, Roanoke, VA 24018-3181 | 2006-04-04 |
| 1528061140 | James Edward Blackwell | Radiology | 1906 Belleview, Roanoke, VA 24033 | 2005-05-27 |
| 1730576943 | Seth Andrews | Radiology | 1906 Belleview Ave Se, Roanoke, VA 24014-1838 | 2015-04-26 |
| 1770901530 | Samuel Key | Radiology | 1906 Belleview Ave Se, Roanoke, VA 24014-1838 | 2014-03-30 |
| 1588924013 | Specialized Radiology Services Inc | Radiology | 2840 Electric Rd, Suite 205-a, Roanoke, VA 24018-3551 | 2012-05-17 |
| 1376822080 | Fielding Carter Fitzpatrick | Radiology | 1906 Belleview Ave Se, Roanoke, VA 24014 | 2011-08-11 |
| Find all providers in ROANOKE | ||||
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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.