Beena Jennifer Premkumar, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

0101264489 Issued in VA

Practice address

600 Jackson St
Fredericksburg, VA 22401-5719

Phone

(540) 373-3223

Fax

(540) 371-3753

NPI assigned

Apr 14, 2014

Last updated

Jan 15, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Rappahannock Area Community Services Board

  • Community/Behavioral Health Agency
  • Fredericksburg, VA
  • NPI 1790742153
  Medicare reassignment NPD
• Rappahannock Area Community Services Board

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Stafford, VA
  • NPI 1265190649
  NPD

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

{
    "created_epoch": "1397433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547510400000",
    "number": "1144649567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 JACKSON ST",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224015719",
            "telephone_number": "540-373-3223",
            "fax_number": "540-371-3753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 JACKSON ST",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224015719",
            "telephone_number": "540-373-3223",
            "fax_number": "540-371-3753"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8479 Saint Anthonys Rd",
            "address_purpose": "LOCATION",
            "city": "King George",
            "state": "VA",
            "postal_code": "224853408",
            "country_code": "US",
            "telephone_number": "540-775-9879",
            "fax_number": "540-371-3753",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15 Hope Rd",
            "address_purpose": "LOCATION",
            "city": "Stafford",
            "state": "VA",
            "postal_code": "225547202",
            "country_code": "US",
            "telephone_number": "540-659-2725",
            "fax_number": "540-371-3753",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PREMKUMAR",
        "first_name": "BEENA",
        "middle_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-14",
        "last_updated": "2019-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MS",
            "license": "T-3193",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "VA",
            "license": "0101264489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08380581",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alec Pratt, MS, CCC-SLP
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• Premier Physical Therapy
• Mark Pressler
• Prestige Health Homcare Solutions LLC
• Sarah Crocker Preuss, COTA
• Shannon Crystal Prevost
• Price & Burrows Behavioral Healthcare

• Child & Adolescent Psychiatry Physician in Fredericksburg, VA
• Providers in Fredericksburg, VA by specialty
• Child & Adolescent Psychiatry Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.