MICHAEL SCOTT BERGMAN, CRNA — NPI 1972517977 (Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered in SOUTHAVEN, MS)

CMS-1500 Box 24J / 33a • NPI

1972517977

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

367500000X (CMS 43)

Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered

Box 32 Service Location & ZIP+4

7601 SOUTHCREST PKWY, SOUTHAVEN, MS, 38671-4739

✓ 9-Digit EDI 837 ZIP+4 (38671-4739)

Practice Phone & Referral Fax

(662) 349-4000

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1972517977 (MICHAEL SCOTT BERGMAN, CRNA) 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	`1972517977` (NPI-1 Individual Practitioner)
Provider / Legal Name	MICHAEL SCOTT BERGMAN, CRNA
Plain-English Specialty	Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered NUCC Code: `367500000X` (Nurse Anesthetist, Certified Registered)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	7601 SOUTHCREST PKWY, SOUTHAVEN, MS, 38671-4739
Practice Telephone / Fax	Tel: (662) 349-4000
Administrative Mailing Address	929 FALLEN OAKS DR, COLLIERVILLE, TN, 38017-3540
Enumeration & Last Sync	Enumerated: 2006-07-28 \| CMS Record Updated: 2024-08-21

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

7601 SOUTHCREST PKWY, SOUTHAVEN, MS, 38671-4739

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Plain-English Taxonomy & CMS Crosswalk (367500000X)

What Does Taxonomy Code 367500000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 367500000X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 43 (Certified Registered Nurse Anesthetist (CRNA))
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Nurse Anesthetist, Certified Registered for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (MICHAEL SCOTT BERGMAN, CRNA)

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
`367500000X` — Nurse Anesthetist, Certified Registered Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered	State: WY \| License: `1322` \| Primary: Secondary
`367500000X` — Nurse Anesthetist, Certified Registered Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered	State: MS \| License: `A810193` \| Primary: Secondary
`367500000X` — Nurse Anesthetist, Certified Registered Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered	State: UT \| License: `273250-3120` \| Primary: Secondary
`367500000X` — Nurse Anesthetist, Certified Registered Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered	State: OR \| License: `200860036` \| Primary: Secondary
`367500000X` — Nurse Anesthetist, Certified Registered Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered	State: WA \| License: `AP60225469` \| Primary: Secondary
`367500000X` — Nurse Anesthetist, Certified Registered Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered	State: ID \| License: `RNA-899` \| Primary: Secondary
`367500000X` — Nurse Anesthetist, Certified Registered Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered	State: IA \| License: `D161234` \| Primary: Secondary
`367500000X` — Nurse Anesthetist, Certified Registered Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered	State: KS \| License: `43557575072` \| Primary: Secondary
`367500000X` — Nurse Anesthetist, Certified Registered Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered	State: NV \| License: `CRNA000533` \| Primary: Secondary
`367500000X` — Nurse Anesthetist, Certified Registered Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered	State: MT \| License: `APRN130636` \| Primary: Secondary
`367500000X` — Nurse Anesthetist, Certified Registered Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered	State: NM \| License: `58180` \| Primary: Yes (Primary)

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MICHAEL SCOTT BERGMAN, CRNA (NPI #1972517977)