Individual provider Active NPI

Renu Sadanandan

  • Psychiatric/Mental Health Nurse Practitioner
  • Richmond, VA
National Provider Identifier
1174909733
Registry record updated Aug 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0001193214 Issued in VA
Practice address
1510 N 28TH St
Suite 101
Richmond, VA 23223-5311
Phone
(804) 371-1670
Fax
(804) 371-1671
NPI assigned
Aug 6, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2015

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 0001193214 VA Primary

Addresses

Primary practice location

1510 N 28TH St
Suite 101
Richmond, VA 23223-5311

Mailing address

1510 N 28TH St
Suite 101
Richmond, VA 23223-5311
Phone (804) 371-1670

Other identifiers 1

IdentifierTypeStateIssuer
C06115OtherVAGROUP PTAN

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151231001611 VA Practitioner - Nurse Practitioner 7012219462 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
District 19 Community Services BoardGroup PAC ID 4082502398, 7 clinicians

Practice addresses (Care Compare)

20 W Bank St
Suite 6
Petersburg, VA 23803-3279
Phone (804) 862-8054

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0001193214VAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
District 19 Community Services Board CurrentSince Jun 19, 2023 Accepting new patients
Bon Secours Memorial Regional Medical Center Inc Past Accepting new patients
Bon Secours Memorial Regional Medical Center Past Accepting new patients

Locations

1101 Greensville County Cir
Emporia, VA 23847
Phone (434) 348-8900

20 W Bank St
Ste 4
Petersburg, VA 23803

20 W Bank St
Ste 2
Petersburg, VA 23803
Phone (804) 861-6606

20 W Bank St
Ste 6
Petersburg, VA 23803
Phone (804) 835-5425

20 W Bank St
Ste 9
Petersburg, VA 23803

4910 Prince George Dr
Prince George, VA 23875
Phone (804) 541-8660

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.

NPI Registry JSON

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

{
    "created_epoch": "1438819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438819200000",
    "number": "1174909733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 N 28TH ST",
            "address_2": "SUITE 101",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232235311",
            "telephone_number": "804-371-1670",
            "fax_number": "804-371-1671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 N 28TH ST",
            "address_2": "SUITE 101",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232235311",
            "telephone_number": "804-371-1670",
            "fax_number": "804-371-1671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SADANANDAN",
        "first_name": "RENU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-06",
        "last_updated": "2015-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0001193214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "C06115",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.