Individual provider Active NPI

Marcella Bowen, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Chesapeake, VA
National Provider Identifier
1003329020
Registry record updated Jun 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0024175576 Issued in VA
Practice address
809 Kent PL
Chesapeake, VA 23320-0768
Phone
(757) 426-0605
NPI assigned
Nov 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0024175576 VA Primary

Addresses

Primary practice location

809 Kent PL
Chesapeake, VA 23320-0768

Mailing address

1545 Crossways Blvd Ste 250
Chesapeake, VA 23320-0218
Phone (757) 541-8390

Other practice location 1

1545 Crossways Blvd Ste 250
Chesapeake, VA 23320-0218
Phone (757) 541-8390

Other names 1

  • Marcella Kennedy Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180213001723 VA Practitioner - Nurse Practitioner 6204196207 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1545 Crossways Blvd
Suite 250
Chesapeake, VA 23320-0218
Phone (757) 541-8390

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Grateful Mind Mental Health Services Inc CurrentSince Jul 1, 2023 Accepting new patients
Coastal Counseling Center Inc CurrentSince Jun 15, 2020 Accepting new patients
Ronald W. Atwood, M.D., P.C. Past Accepting new patients

Locations

809 Kent Pl
Chesapeake, VA 23320
Phone (757) 436-0605

1417 Battlefield Blvd N
Ste 260
Chesapeake, VA 23320
Phone (757) 436-0605

1545 Crossways Blvd
Ste 250
Chesapeake, VA 23320
Phone (757) 206-2772

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1510531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1003329020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1545 CROSSWAYS BLVD STE 250",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233200218",
            "telephone_number": "757-541-8390",
            "fax_number": "484-328-6552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 KENT PL",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233200768",
            "telephone_number": "757-426-0605"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1545 Crossways Blvd Ste 250",
            "address_purpose": "LOCATION",
            "city": "Chesapeake",
            "state": "VA",
            "postal_code": "233200218",
            "country_code": "US",
            "telephone_number": "757-541-8390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOWEN",
        "first_name": "MARCELLA",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-13",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024175576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARCELLA",
            "last_name": "KENNEDY",
            "credential": "PMHNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chesapeake, VA

Sources for this page

Verify at the official NPI Registry.