NPIMap

Individual provider Active NPI

Mary A Bjorkman, NP

  • Nurse Practitioner
  • Virginia Beach, VA
National Provider Identifier
1023296399
Registry record updated Oct 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0024167703 Issued in VA
Practice address
1368 N Great Neck Rd
Virginia Beach, VA 23454-2230
Phone
(757) 412-0006
NPI assigned
Feb 8, 2008
Last updated
Oct 27, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0024167703 VA Primary
General Practice Registered Nurse 163WG0000X 0001198755 VA

Addresses

Primary practice location

1368 N Great Neck Rd
Virginia Beach, VA 23454-2230

Mailing address

1368 N Great Neck Rd
Virginia Beach, VA 23454-2230

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080620000372 VA Practitioner - Nurse Practitioner 4486725306 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Reboot Functional Health Care CorporationGroup PAC ID 1052796604, 5 clinicians

Practice addresses (Care Compare)

2528 Las Brisas Dr
Virginia Beach, VA 23456-4264
Phone (757) 301-6985

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0001198755VAMDGeneral Practice Registered Nurse
0024167703VAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Reboot Functional Health Care Corporation CurrentSince May 21, 2022 Accepting new patients
Beach Counseling, LLC CurrentSince May 21, 2022 Accepting new patients
Comprehensive Medical Center I Inc Past Accepting new patients
Minor Emergency and Family Care Center PastSince Jun 1, 2011 Accepting new patients

Locations

2528 Las Brisas Dr
Virginia Beach, VA 23456
Phone (757) 301-6985

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3256/brand/1/csg/1/fhir/r4
  • Direct secure messaging: mary.bjorkman.1@29909.direct.athenahealth.com

Organizations & group practices 4

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

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1202428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319673600000",
    "number": "1023296399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1368 N GREAT NECK RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234542230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1368 N GREAT NECK RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234542230",
            "telephone_number": "757-412-0006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BJORKMAN",
        "first_name": "MARY",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-08",
        "last_updated": "2011-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024167703",
            "primary": true
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "VA",
            "license": "0001198755",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.