RY WILLIS BERGUM PMHNP
NPI 1275103459
Nurse Practitioner - Psychiatric/Mental Health in Ashland, VA

Q: What is Ry Bergum's NPI number?

The NPI number for Ry Bergum is 1275103459. It was assigned to this individual provider in the NPPES registry on June 29, 2021.

Q: What is Ry Bergum's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Ry Bergum was last updated on December 9, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since June 29, 2021PECOS EnrolledAccepts Medicare Assignment

12300 WASHINGTON HWY, ASHLAND, VA 23005(804) 365-4200(804) 365-6639 Get Directions Write a Review

NPPES record last updated: December 9, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 9, 2025, Dec 29, 2022, Jun 29, 2021 (3 updates tracked since 2021).

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About Ry Willis Bergum Pmhnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RY WILLIS BERGUM PMHNP (NPI 1275103459) is an individual psychiatric/mental health provider in Ashland, Virginia, licensed in Virginia (0024181720) and active in the NPI registry since June 2021. He is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1275103459

Entity TypeIndividualMale

Primary Taxonomy363LP0808X

Provider Legal NameRY WILLIS BERGUMCredential: PMHNP

Location Address12300 WASHINGTON HWYAshland, VA 23005-7646

Mailing Address12300 Washington HwyAshland, VA 23005-7646 · (804) 365-4200

Phone(804) 365-4200

Fax(804) 365-6639

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateJune 29, 2021

Last NPPES UpdateDecember 9, 20253 updates tracked since enumeration

NPPES CertifiedDecember 9, 2025

✔ NPI 1275103459 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in VA · 0024181720

12300 WASHINGTON HWY, Ashland, VA 23005

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ry Willis Bergum Pmhnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5597251058

PECOS Enrollment IDI20260105002191

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 23005 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$86.88 typical visit price

range $56.19 – $170.30

Typical copayment $21.72 (range $14.04 – $42.57)

Most-billed visit code 99203

Established Patient

$99.13 typical visit price

range $18.07 – $138.91

Typical copayment $24.78 (range $4.51 – $34.72)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KATHY REDFEARN LCSW

Social Worker (Clinical)