Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1013040849 Individual Practitioner Female Practitioner

Breanna K Bergeron , RD

Dietitian, Registered • Spokane, WA

Professional Overview & Biography Verified Profile Summary

Breanna Bergeron, RD is a registered healthcare professional specializing in Dietitian, Registered in Spokane, WA. Practice services are available at 212 E CENTRAL AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

212 E Central Ave
Ste. 440

Spokane, WA 992086291

Telephone 5092529602
Fax 5092277070
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dietitian, Registered in Spokane, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 15.2 Yrs
State Avg: 14.4 Yrs
Regional Practice Density
151 Specialists

Practicing in Spokane, WA (2154 Statewide)

Telehealth Adoption Rate
2.0% 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

Dietitian, Registered Primary Specialty

NUCC Taxonomy Code: 133V00000X

State License WA DI60595970

A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.

Dietitian, Registered

NUCC Taxonomy Code: 133V00000X

State License AK 175

A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.

Dietitian, Registered

NUCC Taxonomy Code: 133V00000X

State License ID D-530

A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
DT9813 (AK)

Practice Associates & Co-Workers

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

40 Associated Practitioners
NPI 1003374265
NPI 1003811712

Doctor of Philosophy (Ph.D.)

Dr. Robert Wales , MD, FACC

Internal Medicine - Cardiovascular Disease

NPI 1003820275

Doctor of Medicine (M.D.), FACC

Kevin Kellogg , PA-C

Physician Assistant - Surgical

NPI 1003899493

Physician Assistant (Certified)

NPI 1013086693

Doctor of Medicine (M.D.)

Dr. Stacey Clark , MD

Emergency Medicine

NPI 1013170869

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

11 Historical Events
NPI Profile Active March 24, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location March 24, 2017

Registered at 212 E CENTRAL AVE, STE. 440, SPOKANE, WA 992086291 (Tel: 5092529602)

📍
Updated Business Mailing Address March 24, 2017

Registered at PO BOX 421, LIBERTY LAKE, WA 990190421 (Tel: 8667472455)

👤
Provider Name / Credentials Updated March 24, 2017

Recorded as BREANNA BERGERON, RD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 24, 2017

Dietitian, Registered (License #175 in AK)

NPI Profile Active October 20, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location October 20, 2016

Registered at 2003 KOOTENAI HEALTH WAY, ATTN SHERRY REEDY, COEURD' ALENE, ID 83814 (Tel: 2086662000)

📍
Updated Business Mailing Address October 20, 2016

Registered at PO BOX 421, ATTN SHERRY REEDY, LIBERTY LAKE, WA 990190421 (Tel: 8667472455)

👤
Provider Name / Credentials Updated October 20, 2016

Recorded as BREANNA BERGERON, RD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 20, 2016

Dietitian, Registered (License #D-530 in ID)

🟢
Initial NPI Registration & Enumeration March 13, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1013040849
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 13, 2007
Last Update: March 24, 2017
Sole Proprietor: No

Mailing Address

Po Box 421

Liberty Lake, WA 990190421

Phone: 8667472455

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.