Kennedy Bergren, PA-C
NPI 1063361103 · Physician Assistant · Coon Rapids, MN
Kennedy Bergren, PA-C is a Physician Assistant provider in Coon Rapids, MN (NPI 1063361103).
Provider details
- NPI number
- 1063361103
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- License
- 15701 (MN)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2026-01-22
- Last updated
- 2026-05-05
- Certified
- 2026-05-05
Frequently asked questions
- What is Kennedy Bergren's NPI number?
- Kennedy Bergren's National Provider Identifier (NPI) is 1063361103, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Kennedy Bergren's specialty?
- Kennedy Bergren is listed in the NPPES registry with a primary specialty of Physician Assistant (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Kennedy Bergren located?
- Kennedy Bergren's practice location on file with NPPES is 9055 Springbrook Dr Nw, Coon Rapids, MN 55433-5841.
- What is Kennedy Bergren's phone number?
- The practice phone number listed in the NPPES registry for Kennedy Bergren is (763) 780-9155.
- Is Kennedy Bergren's NPI active?
- Yes — Kennedy Bergren's NPI (1063361103) is active in the NPPES registry as of the last update on 2026-05-05.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.