Active NPI
Angela Harris-Bonner, APRN, PMHNP
- Psychiatric/Mental Health Nurse Practitioner
- Petersburg, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 0024186586
- Practice address
- 28 Goodrich Ave
Petersburg, VA 23805 - Phone
- (804) 621-5128
- NPI assigned
- May 29, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 0001211239 | VA | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 0024186586 | VA | Primary |
Addresses
Primary practice location
28 Goodrich Ave
Petersburg, VA 23805
Mailing address
28 Goodrich Ave
Petersburg, VA 23805-2120
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
107 S 5TH St
Richmond, VA 23219-3825
Phone (804) 819-4000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0001211239 | VA | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Legacy Care Aco LLC | Current | Accepting new patients | |
| Unlimited Wellness Psychiatric Services | Current | Accepting new patients | |
| Richmond Behavioral Health Authority | Current | Accepting new patients |
Locations
7600 Autumn Park Way
Mechanicsvlle, VA 23116
Phone (804) 730-0009
107 S 5th St
Richmond, VA 23219
Phone (804) 819-4000
780 Lynnhaven Pkwy
Ste 400
Virginia Beach, VA 23452
Phone (201) 581-3411
2901 S Lynnhaven Rd
Ste 450
Virginia Beach, VA 23452
Phone (757) 351-4585
Interoperability endpoints
- https://api.platform.athenahealth.com/17274/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.
-
- Community/Behavioral Health Agency
- Richmond, VA
- NPI 1184715328
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Chester, VA
- NPI 1215775903
-
- Family Medicine Physician
- Virginia BCH, VA
- NPI 1538844857
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678752000000",
"number": "1134566334",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28 GOODRICH AVE",
"city": "PETERSBURG",
"state": "VA",
"postal_code": "238052120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28 GOODRICH AVE",
"city": "PETERSBURG",
"state": "VA",
"postal_code": "23805",
"telephone_number": "804-621-5128"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS-BONNER",
"first_name": "ANGELA",
"credential": "APRN, PMHNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-05-29",
"last_updated": "2023-03-14",
"certification_date": "2023-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "VA",
"license": "0001211239",
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "VA",
"license": "0024186586",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Petersburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.