Individual provider Active NPI

Renae Bergeron

  • Nurse Practitioner
  • Virginia Beach, VA
National Provider Identifier
1215810932
Registry record updated Mar 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0024196466 Issued in VA
Practice address
1205 Bartlett Oaks CT
Virginia Beach, VA 23456-6853
Phone
(985) 474-0181
NPI assigned
Jul 29, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0024196466 VA Primary

Addresses

Primary practice location

1205 Bartlett Oaks CT
Virginia Beach, VA 23456-6853

Mailing address

1205 Bartlett Oaks CT
Virginia Beach, VA 23456-6853
Phone (985) 474-0181

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
I20260414002173 VA Practitioner - Nurse Practitioner 7618443045 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1205 Bartlett Oaks CT
Virginia Beach, VA 23456-6853

4535 Dressler Rd NW
Canton, OH 44718-2545

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0024196466VAMDNurse Practitioner

Organizations & group practices 1

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": "1753747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774310400000",
    "number": "1215810932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 BARTLETT OAKS CT",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234566853",
            "telephone_number": "985-474-0181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 BARTLETT OAKS CT",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234566853",
            "telephone_number": "985-474-0181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGERON",
        "first_name": "RENAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-29",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024196466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.