TRAE JORDAN BERGH (NPI# 1992286223) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992286223 |
| Entity Type | Individual |
| Full Name | TRAE JORDAN BERGH |
| Credential | PA-C |
| Practice Address |
575 N Sioux Point Rd Dakota Dunes SD 57049-5312 |
| Mailing Address |
3016 S Keyrell Dr Sioux Falls SD 57106-7304 |
| Practice Telephone | 6052172667 |
| Mailing Telephone | 6055536458 |
| Enumeration Date | 2018-08-24 |
| Last Update Date | 2020-02-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
1156 | SD | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
575 N SIOUX POINT RD |
| City | DAKOTA DUNES |
| State | SD |
| Zip Code | 57049-5312 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992708853 | James Lawrence Case | Psychiatry & Neurology | 575 N Sioux Point Rd, Dakota Dunes, SD 57049-5312 | 2005-05-24 |
| 1053911123 | Tyson David Allen | Physician Assistant | 575 N Sioux Point Rd, Dakota Dunes, SD 57049-5312 | 2020-10-28 |
| 1265032544 | Allison Faye Biggerstaff | Registered Nurse | 575 N Sioux Point Rd, Dakota Dunes, SD 57049-5312 | 2020-10-27 |
| 1114524378 | Rosa Maria Marquez | Physician Assistant | 575 N Sioux Point Rd, Dakota Dunes, SD 57049-5312 | 2020-10-01 |
| 1174140552 | Nicole Kay Shea | Registered Nurse | 575 N Sioux Point Rd, Dakota Dunes, SD 57049-5312 | 2020-07-01 |
| 1932734191 | Trisha Marie Anderson | Physician Assistant | 575 N Sioux Point Rd, Dakota Dunes, SD 57049-5312 | 2020-03-09 |
| 1407494388 | Martin R Walsh | Physical Therapist | 575 N Sioux Point Rd, Dakota Dunes, SD 57049-5312 | 2019-12-11 |
| 1437713872 | Daniel Eric Nelson | Specialist/Technologist | 575 N Sioux Point Rd, Dakota Dunes, SD 57049-5312 | 2019-04-30 |
| 1023574316 | Nicholas Nielsen | Physical Therapist | 575 N Sioux Point Rd, Dakota Dunes, SD 57049-5312 | 2019-02-12 |
| 1417435462 | Allison Ruth Owings | Registered Nurse | 575 N Sioux Point Rd, Dakota Dunes, SD 57049 | 2018-08-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093356800 | Dennis Alan Bickett | Physical Therapist | 365 W Anchor Drive, North Sioux City, SD 57049 | 2019-10-02 |
| 1053872416 | Ryan Joel Anderson | Nurse Anesthetist, Certified Registered | Address: 101 Tower Rd, Suite 201, Dakota Dunes, SD 57049 | 2019-03-28 |
| 1043769656 | Jeffrey L Howenstein Dmd Ms PC | Dentist | 711 Sioux Point Rd., Ste. 100, Dakota Dunes, SD 57049 | 2016-09-23 |
| 1821445206 | Abbie A Gacke | Speech-Language Pathologist | 101 Tower Rd Ste 120, Dakota Dunes, SD 57049 | 2016-05-16 |
| 1346606233 | Seth Wolles | Specialist/Technologist | 575 Sioux Point Rd, Dakota Dunes, SD 57049 | 2016-01-07 |
| 1598188252 | Hanger Prosthetics & Orthotics East Inc | Prosthetic/Orthotic Supplier | 330 Dakota Dunes Blvd Ste 150, Dakota Dunes, SD 57049 | 2014-01-30 |
| 1932220217 | Campbell Chiropractic Clinic PC | Chiropractor | 118 Gateway Dr, N. Sioux City, SD 57049 | 2007-04-03 |
| 1912048687 | North Sioux Dental Clinic | Dentist | 101 Merrill Ave., North Sioux City, SD 57049 | 2007-02-08 |
| 1346322716 | Donald B Cork Jr. | Dentist | 101 Merrill Ave, North Sioux City, SD 57049 | 2006-10-19 |
| 1265514681 | Bethany R Nielsen | Dentist | 101 Merrill Ave, Box 1010, North Sioux City, SD 57049 | 2006-10-19 |
| Find all providers in zip 57049 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790746105 | Nichole Renae Friessen | Physician Assistant | 575 Sioux Point Road, Dakota Dunes, SD 57049 | 2006-03-28 |
| 1053911123 | Tyson David Allen | Physician Assistant | 575 N Sioux Point Rd, Dakota Dunes, SD 57049-5312 | 2020-10-28 |
| 1114524378 | Rosa Maria Marquez | Physician Assistant | 575 N Sioux Point Rd, Dakota Dunes, SD 57049-5312 | 2020-10-01 |
| 1932734191 | Trisha Marie Anderson | Physician Assistant | 575 N Sioux Point Rd, Dakota Dunes, SD 57049-5312 | 2020-03-09 |
| 1205362282 | Chase Beiermann | Physician Assistant | 575 N Sioux Point Rd, Dakota Dunes, SD 57049-5312 | 2017-05-11 |
| 1568868610 | Ashton Tyler Redstone | Physician Assistant | 575 N Sioux Point Rd, Dakota Dunes, SD 57049-5312 | 2014-11-17 |
| 1750528733 | Batsirai Mutize | Physician Assistant | 575 N Sioux Point Rd, Dakota Dunes, SD 57049-5312 | 2009-01-14 |
| 1699938092 | Cristin Renae Vander Weerdt | Physician Assistant | 575 N Sioux Point Rd, Dakota Dunes, SD 57049-5312 | 2008-07-07 |
| 1073690814 | Reed Barton Mcgill | Physician Assistant | 575 N Sioux Point Rd, Dakota Dunes, SD 57049-5312 | 2006-11-01 |
| 1790862076 | Jessica A Prewitt-emerson | Physician Assistant | 575 Sioux Point Road, Dakota Dunes, SD 57049 | 2006-11-01 |
| Find all providers in DAKOTA DUNES | ||||
| City | DAKOTA DUNES |
| Zip Code | 57049 |
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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.