Individual provider Active NPI

Veronicah Banga

  • Psychiatric/Mental Health Nurse Practitioner
  • Richardson, TX
National Provider Identifier
1164011284
Registry record updated Feb 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1017145 Issued in TX
Practice address
1750 N Collins Blvd Ste 106
Richardson, TX 75080-3551
Phone
(410) 522-8103
NPI assigned
Jan 13, 2021
Last updated
Feb 18, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2021

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 1017145 TX Primary

Addresses

Primary practice location

1750 N Collins Blvd Ste 106
Richardson, TX 75080-3551

Mailing address

3312 Glenmore Dr
Melissa, TX 75454-2585
Phone (410) 522-8103

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20210322001412 TX Practitioner - Nurse Practitioner 7719394667 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1017145TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rose Psychiatric Associate PLLC Psychiatric/Mental Health CurrentSince Mar 29, 2023 Accepting new patients
North Star Psychiatry PLLC CurrentSince Feb 1, 2021 Accepting new patients

Locations

409 S Central Expy
Ste 107514
Anna, TX 75409
Phone (469) 545-0902

3447 Renner Rd
#120
Plano, TX 75074
Phone (469) 384-2989

Organizations & group practices 2

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": "1610496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1164011284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3312 GLENMORE DR",
            "city": "MELISSA",
            "state": "TX",
            "postal_code": "754542585",
            "telephone_number": "410-522-8103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 N COLLINS BLVD STE 106",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750803551",
            "telephone_number": "410-522-8103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANGA",
        "first_name": "VERONICAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-13",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1017145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richardson, TX

Sources for this page

Verify at the official NPI Registry.