JESSICA LEIGH BERGSTROM (NPI# 1497290282) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497290282 |
| Entity Type | Individual |
| Full Name | JESSICA LEIGH BERGSTROM |
| Credential | PA-C |
| Practice Address |
605 W State St Media PA 19063-2620 |
| Practice Telephone | 6105658600 |
| Practice Fax Number | 6108919238 |
| Mailing Telephone | 6105658600 |
| Mailing Fax Number | 6108919238 |
| Enumeration Date | 2017-01-03 |
| Last Update Date | 2019-09-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | MA058785 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 801 Ostrum St, Bethlehem, PA 180151000 | 4845266643 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508333618 | Jessica Bergstrom | Psychologist | 710 S Broadway, Walnut Creek, CA 94596-5294 | 2018-10-26 |
| 1952689119 | Jessica Bergstrom | Pharmacist | 301 Strander Blvd, T-0627, Tukwila, WA 98188-2971 | 2011-07-21 |
| Street Address |
605 W STATE ST |
| City | MEDIA |
| State | PA |
| Zip Code | 19063-2620 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205863198 | Daniel E Soffer | Internal Medicine | 605 W State St, Media, PA 19063-2620 | 2006-06-27 |
| 1871097246 | Kristin Leigh Stokotelny | Dietitian, Registered | 605 W State St, Media, PA 19063-2620 | 2018-03-21 |
| 1952837767 | Anna Marie Kanyuck | Family Medicine | 605 W State St, Media, PA 19063-2620 | 2017-05-11 |
| 1649536905 | Cara L Kitaeff | Physician Assistant | 605 W State St, Media, PA 19063-2620 | 2012-04-11 |
| 1588975163 | Jamie Lee Paik | Internal Medicine | 605 W State St, Media, PA 19063-2620 | 2010-06-29 |
| 1497078893 | Donald D Wallace | Physical Therapist | 605 W State St, First Floor, Media, PA 19063-2620 | 2010-03-12 |
| 1851427058 | Adeyemi Daramola | Chiropractor | 605 W State St, Media, PA 19063-2620 | 2007-02-24 |
| 1740337013 | Aaron Edward Myers | Physical Therapist | 605 W State St, First Floor, Media, PA 19063-2620 | 2007-01-05 |
| 1174680474 | John Edward Mccarrin | Chiropractor | 605 W State St, Media, PA 19063-2620 | 2007-01-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538766837 | Kimberly Ann Martyn | Nurse Practitioner | 168 W Baltimore Pike, Media, PA 19063 | 2020-10-08 |
| 1366060220 | Yinka Read | Clinical Neuropsychologist | 1088 W. Baltimore Pike, Healthcare II, Suite 2205, Media, PA 19063 | 2020-07-08 |
| 1306304522 | Caroline Dickerson | Speech-Language Pathologist | 510 Williamson Cir, Media, PA 19063 | 2019-03-06 |
| 1528544178 | Dayeon Cho | Nurse Practitioner | 1400 North Providence Road, Suite 1020, Rose Tree Corporate Center, Building 2, Media, PA 19063 | 2018-07-17 |
| 1235621400 | Joseph Savukinas | Registered Nurse | Mirmont Treatment Center, 100 Yearsley Mill Rd, Media, PA 19063 | 2018-06-04 |
| 1003331281 | Accredited Environmental Technologies, Inc. | Contractor | 28 N. Pennell Road, Media, PA 19063 | 2017-08-08 |
| 1538684220 | Holcomb Associates Inc. | Clinic/Center | 126 East Baltimore Pike, Gayley Square, Media, PA 19063 | 2017-08-03 |
| 1619498334 | Bryan Allen Mizell | Specialist/Technologist | 324 Crestview Circle, Media, PA 19063 | 2017-07-03 |
| 1427597970 | Grow Now Therapy Services LLC. | Speech-Language Pathologist | 600 N Jackson Street, Media, PA 19063 | 2017-02-16 |
| 1720520216 | Kathryn Rauch | Counselor | 107 Chesley Drive Unit #5, Media, PA 19063 | 2016-11-15 |
| Find all providers in zip 19063 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518502178 | Andrew Gardner | Physician Assistant | 200 E State St Ste 205, Media, PA 19063-3434 | 2019-11-07 |
| 1801308515 | Amanda Lynn Mcgough | Physician Assistant | 1098 W Baltimore Pike, Media, PA 19063-5139 | 2017-11-02 |
| 1790113587 | Nancy Sanfrancesco | Physician Assistant | 176 S New Middletown Rd Ste 203, Media, PA 19063-5255 | 2013-10-15 |
| 1518201466 | Jennifer Lynn Leman | Physician Assistant | 1098 W Baltimore Pike, Suite 3402, Media, PA 19063-5139 | 2012-11-15 |
| 1649536905 | Cara L Kitaeff | Physician Assistant | 605 W State St, Media, PA 19063-2620 | 2012-04-11 |
| 1881987949 | Dana M Cavalcanto | Physician Assistant | 200 State Street, Suite 205, Media, PA 19063-3434 | 2011-05-24 |
| 1568755627 | Julia R Brown | Physician Assistant | 200 E State St Ste 205, Media, PA 19063-3434 | 2011-05-24 |
| 1689967747 | Alaina Jacobi Vincent | Physician Assistant | 200 E State St Ste 205, Media, PA 19063-3434 | 2011-05-24 |
| 1477851822 | Kara B Matsco | Physician Assistant | 1068 W Baltimore Pike, Media, PA 19063-5104 | 2011-03-09 |
| 1912214958 | Alyssa Brianne Snow | Physician Assistant | 1068 W Baltimore Pike, Media, PA 19063-5104 | 2010-09-13 |
| Find all providers in MEDIA | ||||
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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.