Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1063361103 Individual Practitioner Female Practitioner

Kennedy Bergren , PA-C

Physician Assistant • Coon Rapids, MN

Public Directory Information & Medical Disclaimer

This profile is compiled from official public domain records provided by CMS and the NPPES registry. TRUE-MEDINFO is an independent reference directory and does not provide medical advice, diagnosis, or treatment recommendations. Always consult a licensed medical professional for personal health decisions.

Professional Overview & Biography Verified Profile Summary

Kennedy Bergren, PA-C is a registered healthcare professional specializing in Physician Assistant in Coon Rapids, MN. Official NPI practice address is registered at 9055 SPRINGBROOK DR NW.

Practice Location & Contact Primary Location

Practice Address

9055 Springbrook Dr Nw

Coon Rapids, MN 554335841

Telephone 7637809155
Associated Practice Facility / Clinic
🏢 Ambor Corporation Facility NPI 1932236130

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Coon Rapids, MN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 8.8 Yrs
State Avg: 10.9 Yrs
Regional Practice Density
83 Specialists

Practicing in Coon Rapids, MN (4026 Statewide)

Telehealth Adoption Rate
30.1% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-05-05
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License MN 15701

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Blythe Nelson , LICSW

Social Worker - Clinical

NPI 1003156761

Licensed Independent Clinical Social Worker

NPI 1003878091

Doctor of Optometry

Dr. Suzanne Witterholt , MD

Psychiatry & Neurology - Pain Medicine

NPI 1013018688

Doctor of Medicine (M.D.)

Dr. Abby Stanislaw , PsyD

Psychologist - Clinical

NPI 1013242536

Doctor of Psychology (Psy.D.)

NPI 1013409523

Doctor of Audiology

Dr. Emily Strange , DPT

Physical Therapist

NPI 1013675487

Doctor of Physical Therapy

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 05, 2026

Physician Assistant (License #15701 in MN)

NPI Profile Active January 22, 2026

NPI status registered as active in NPPES database

📍
Updated Practice Location January 22, 2026

Registered at 9055 SPRINGBROOK DR NW, COON RAPIDS, MN 554335841 (Tel: 7637809155)

📍
Updated Business Mailing Address January 22, 2026

Registered at 9055 SPRINGBROOK DR NW, COON RAPIDS, MN 554335841

👤
Provider Name / Credentials Updated January 22, 2026

Recorded as KENNEDY BERGREN, PA-C

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 22, 2026

Physician Assistant

🟢
Initial NPI Registration & Enumeration January 22, 2026

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1063361103
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 22, 2026
Last Update: May 05, 2026
Sole Proprietor: No

Mailing Address

9055 Springbrook Dr Nw

Coon Rapids, MN 554335841

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.