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Deactivated NPI 1043442304 Deactivated / Inactive NPI Female Practitioner

Beverly Jean Bergum , RN

Registered Nurse - General Practice • Perham, MN

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Beverly Bergum has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 19, 2009
NPI Deactivation Date December 16, 2019
Total Practice Duration ~10 Years of Practice (2009 – 2019)

Professional Overview & Biography Verified Profile Summary

Beverly Bergum, RN was a registered Registered Nurse - General Practice practicing in Perham, MN. Throughout an active medical career spanning 10 years, Beverly Bergum provided care at the practice location at 812 4TH AVE SW until profile deactivation on 2019-12-16.

Practice Location & Contact Primary Location

Practice Address

812 4th Ave Sw

Perham, MN 565731632

Telephone 2183463266

Specialty Benchmarks & Practice Insights

Comparative analytics for Registered Nurse - General Practice in Perham, MN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
1 Specialists

Practicing in Perham, MN (95 Statewide)

Telehealth Adoption Rate
0.0% 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

Registered Nurse - General Practice Primary Specialty

NUCC Taxonomy Code: 163WG0000X

State License MN R88457-2

Definition to come...

Career & Practice History Timeline

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

7 Historical Events
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NPI Profile Deactivated December 16, 2019

Record deactivated on December 16, 2019

NPI Profile Active August 19, 2009

NPI status registered as active in NPPES database

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Updated Practice Location August 19, 2009

Registered at 812 4TH AVE SW, PERHAM, MN 565731632 (Tel: 2183463266)

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Updated Business Mailing Address August 19, 2009

Registered at 812 4TH AVE SW, PERHAM, MN 565731632 (Tel: 2183463266)

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Provider Name / Credentials Updated August 19, 2009

Recorded as BEVERLY BERGUM, RN

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Medical Taxonomy / Specialty Registered (Primary Specialty) August 19, 2009

Registered Nurse (License #R88457-2 in MN)

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Initial NPI Registration & Enumeration August 19, 2009

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: 1043442304
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 19, 2009
Last Update: August 19, 2009
Deactivation Date: December 16, 2019

Mailing Address

812 4th Ave Sw

Perham, MN 565731632

Phone: 2183463266

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.