NICOLE MARIE BERGMAN (NPI# 1639468184) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639468184 |
| Entity Type | Individual |
| Full Name | NICOLE MARIE BERGMAN |
| Credential | PA-C |
| Practice Address |
702 Commerce Dr Suite 100 Perrysburg OH 43551-5239 |
| Mailing Address |
815 Commerce Dr Suite 100 Perrysburg OH 43551-5255 |
| Practice Telephone | 4198724673 |
| Practice Fax Number | 4198738329 |
| Mailing Telephone | 4198724673 |
| Mailing Fax Number | 4198738329 |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2016-11-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
50.003246 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | MEDICARE GROUP | 9344881 | 01 |
| OH | RAILROAD MEDICARE GROUP | DD1846 | 01 |
| Street Address |
702 COMMERCE DR SUITE 100 |
| City | PERRYSBURG |
| State | OH |
| Zip Code | 43551-5239 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245233683 | Michael A Healy | Neurological Surgery | 702 Commerce Dr, Ste100, Perrysburg, OH 43551-5239 | 2005-05-31 |
| 1063839520 | Molly Heberling | Physician Assistant | 702 Commerce Dr, Suite 100, Perrysburg, OH 43551-5239 | 2014-03-23 |
| 1700973492 | Perrysburg Family Physicians LLC | Family Medicine | 702 Commerce Dr, Suite 160, Perrysburg, OH 43551-5239 | 2006-10-06 |
| 1134144322 | Hope Terecia Mitchell | Dermatology | 702 Commerce Dr, Perrysburg, OH 43551-5239 | 2006-07-12 |
| 1962442442 | Neurosurgical Network, Inc. | Neurological Surgery | 702 Commerce Dr, Suite 100, Perrysburg, OH 43551-5239 | 2006-06-06 |
| 1932170040 | Michael Allen Neiswander | Family Medicine | 702 Commerce Dr, Suite 160, Perrysburg, OH 43551-5239 | 2006-01-27 |
| 1740250158 | Catherine G Carrigan | Family Medicine | 702 Commerce Dr, Suite 160, Perrysburg, OH 43551-5239 | 2006-01-26 |
| 1487650271 | Jeffrey Frank Wirebaugh | Family Medicine | 702 Commerce Dr, Ste 160, Perrysburg, OH 43551-5271 | 2005-06-26 |
| 1104822998 | Leslie Joseph Domini | Family Medicine | 702 Commerce Dr, Ste 160, Perrysburg, OH 43551-5271 | 2005-06-26 |
| 1922004712 | Robert Marc Donawa | Family Medicine | 702 Commerce Dr, Ste 160, Perrysburg, OH 43551-5271 | 2005-06-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467067744 | Jacob Burmeister | Psychologist | 1070 Commerce, Building 2, Suite 301, Perrysburg, OH 43551 | 2020-09-13 |
| 1487136727 | Urgent Care Travel, Inc | Clinic/Center | 26415 Warns Road, Lake Township, OH 43551 | 2018-09-04 |
| 1770060527 | Marissa Lynn Dukes | Nurse Practitioner | 3120 Chappel Dr, Perrysburg, OH 43551 | 2018-07-24 |
| 1063999373 | Misty Mary Anne Sheeks-mejri | Registered Nurse | 181 Birchdale Rd, Perrysburg, OH 43551 | 2018-07-20 |
| 1710406160 | Daniel Saffo | Dentist | 27072c Carronade Dr, Perrysburg, OH 43551 | 2017-09-18 |
| 1053835389 | Derrick J Erman | Pharmacist | 10255 Desmond Place, Perrysburg, OH 43551 | 2017-07-28 |
| 1205357167 | Angela Elaine Howard | Counselor | 800 Commerce Dr., Perrysburg, OH 43551 | 2017-06-30 |
| 1306376140 | Hannah Sue Neumeyer | Counselor | 1070 Commerce Drive, Building One, Suite 101, Perrysburg, OH 43551 | 2017-06-14 |
| 1790132199 | Justin Allen Cole | Emergency Medicine | 10421 Scarlet Oak Dr, Perrysburg, OH 43551 | 2016-05-16 |
| 1750742953 | Amy Lynn Graham | Nurse Practitioner | 27386 Corrondale Dr, Perrysburg, OH 43551 | 2016-03-15 |
| Find all providers in zip 43551 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104824655 | Joanna L Ansted | Physician Assistant | 12780 Roachton Rd, Suite 1, Perrysburg, OH 43551-1350 | 2005-07-08 |
| 1790135515 | Jamie Saporita | Physician Assistant | 25950 Dixie Hwy Ste 400, Perrysburg, OH 43551-2983 | 2016-06-14 |
| 1962873331 | Julie Gilson | Physician Assistant | 28555 Starbright Blvd Ste B, Perrysburg, OH 43551-5662 | 2015-10-12 |
| 1902221443 | Maureen E Mccarthy | Physician Assistant | 12780 Roachton Rd # 1, Perrysburg, OH 43551-1350 | 2014-02-20 |
| 1528017076 | Elizabeth A Mayer | Physician Assistant | 28555 Starbright Blvd, Suite B, Perrysburg, OH 43551-5662 | 2006-05-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023618428 | Stephanie Ann Keener | Physician Assistant | 7774 Hythe Cir, Centerville, OH 45459-8705 | 2020-10-27 |
| 1174122600 | Maria Drankov Lane | Physician Assistant | 1806 Muskegon Dr, Cincinnati, OH 45255-2635 | 2020-10-26 |
| 1326647512 | Junell Rutledge | Physician Assistant | 644 High St, Youngstown, OH 44502-1562 | 2020-10-20 |
| 1699372383 | Samantha Kibler | Physician Assistant | 7337 Caritas Cir Nw Ste 150, Massillon, OH 44646-9128 | 2020-10-06 |
| 1982218186 | Morgan Holmes | Physician Assistant | 65 Community Rd Ste F, Tallmadge, OH 44278-2358 | 2020-09-04 |
| 1902456023 | Kara Meyer | Physician Assistant | 2417 Derbyshire Ct, Cleveland Heights, OH 44106-2778 | 2019-09-19 |
| 1679122394 | Mariah Bower | Physician Assistant | 2725 Hampshire Rd Apt 3, Cleveland, OH 44106-2570 | 2019-09-05 |
| 1457908014 | Kristen Fairchild | Physician Assistant | 4235 Secor Rd Bldg 2, Toledo, OH 43623-4231 | 2019-08-19 |
| 1811549462 | Abigail Malsch | Physician Assistant | 2376 Fenwood Rd, University Heights, OH 44118-3804 | 2019-07-14 |
| 1164087466 | Jessica Lee Schulte | Physician Assistant | 1110 West Main Cross St., Findlay, OH 45840-2423 | 2019-05-02 |
| Find all providers with the same taxonomy | ||||
| City | PERRYSBURG |
| Zip Code | 43551 |
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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.