Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Stacy Heather Bergman

Individual provider Occupational Therapy Assistant · NPI 1912538000

Stacy Heather Bergman is an Occupational Therapy Assistant in Ponca City, Oklahoma. Licensed in New Mexico and Oklahoma. Registered with an NPI since 2020.

Licensed in
NM, OK
In the registry since
2020
Specialties on file
2

Practice location Address checks out

1601 Academy Rd
Ponca City, OK 74604-4409
Phone: (580) 340-3728
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapy Assistant (primary) Taxonomy 224Z00000X · Licence OA780 (OK)
Occupational Therapy Assistant Taxonomy 224Z00000X · Licence OT-2026-070 (NM)

Record details

NPI number1912538000
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJanuary 28, 2020
Last updated in NPPESJuly 10, 2026
Certification dateJuly 10, 2026
Mailing address3750 S 13th St, Blackwell, OK 74631-6702

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