KATIE BREANN BERGIN, BCBA — NPI 1386443695 (Licensed & Credentialed Behavior Analyst in RIDGELAND, MS)

CMS-1500 Box 24J / 33a • NPI

1386443695

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

103K00000X

Licensed & Credentialed Behavior Analyst

Box 32 Service Location & ZIP+4

992 NORTHPARK DR, RIDGELAND, MS, 39157-5193

✓ 9-Digit EDI 837 ZIP+4 (39157-5193)

Practice Phone & Referral Fax

(318) 498-2760

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1386443695 (KATIE BREANN BERGIN, BCBA) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1386443695` (NPI-1 Individual Practitioner)
Provider / Legal Name	KATIE BREANN BERGIN, BCBA
Plain-English Specialty	Licensed & Credentialed Behavior Analyst NUCC Code: `103K00000X` (Behavior Analyst)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	992 NORTHPARK DR, RIDGELAND, MS, 39157-5193
Practice Telephone / Fax	Tel: (318) 498-2760
Administrative Mailing Address	4 COUNTY ROAD 2315, LAUREL, MS, 39443-8113
Enumeration & Last Sync	Enumerated: 2025-03-10 \| CMS Record Updated: 2026-03-11

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

992 NORTHPARK DR, RIDGELAND, MS, 39157-5193

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Plain-English Taxonomy & CMS Crosswalk (103K00000X)

What Does Taxonomy Code 103K00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 103K00000X translates to:
"Licensed & Credentialed Behavior Analyst"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Behavior Analyst for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (KATIE BREANN BERGIN, BCBA)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`103K00000X` — Behavior Analyst Plain English: Licensed & Credentialed Behavior Analyst	State: MS \| License: `1-25-79628` \| Primary: Yes (Primary)
`103K00000X` — Behavior Analyst Plain English: Licensed & Credentialed Behavior Analyst	State: PA \| License: `BH007959` \| Primary: Secondary
`103K00000X` — Behavior Analyst Plain English: Licensed & Credentialed Behavior Analyst	State: MA \| License: `LABA10001900` \| Primary: Secondary

Medical Billing, RCM & Hospital Credentialing Teams:

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KATIE BREANN BERGIN, BCBA (NPI #1386443695)