Individual provider Active NPI

Bernadette Veshegho

  • Psychiatric/Mental Health Nurse Practitioner
  • Bowie, MD
National Provider Identifier
1043918428
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R201247 Issued in MD
Practice address
12106 Rustic Hill Dr
Bowie, MD 20715-1035
Phone
(301) 256-5220
NPI assigned
Feb 16, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2025

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 R201247 MD Primary

Addresses

Primary practice location

12106 Rustic Hill Dr
Bowie, MD 20715-1035

Mailing address

12106 Rustic Hill Dr
Bowie, MD 20715-1035
Phone (301) 256-5220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20231113000030 MD Practitioner - Nurse Practitioner 4284081308 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R201247MDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lca Psychological Associates, LLC CurrentSince Sep 24, 2023 Accepting new patients
Premium Care Servies Inc. CurrentSince Apr 16, 2023 Accepting new patients
Lca Psychological Associates, LLC PastSince Feb 24, 2022 Accepting new patients

Locations

11315 Pembrooke Sq
Ste 112A
Waldorf, MD 20603
Phone (301) 645-2233

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1676505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1043918428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12106 RUSTIC HILL DR",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207151035",
            "telephone_number": "301-256-5220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12106 RUSTIC HILL DR",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207151035",
            "telephone_number": "301-256-5220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VESHEGHO",
        "first_name": "BERNADETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-16",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R201247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

Verify at the official NPI Registry.