Individual provider Active NPI

Bernadette Michelle Brewer

  • Psychiatric/Mental Health Nurse Practitioner
  • Brentwood, TN
National Provider Identifier
1316476872
Registry record updated Jun 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
23448 Issued in TN
Practice address
5511 Virginia Way
Ste 300
Brentwood, TN 37027-7611
Phone
(615) 994-1000
Fax
(615) 994-0100
NPI assigned
Jun 8, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 23448 TN Primary
Registered Nurse 163W00000X 173987 TN
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0024190340 VA

Addresses

Primary practice location

5511 Virginia Way
Ste 300
Brentwood, TN 37027-7611

Mailing address

5511 Virginia Way
Ste 300
Brentwood, TN 37027-7611
Phone (615) 994-1000

Other practice location 1

249 Central Park Avenue
Ste 300-161
Virginia Beach, VA 23462-3099
Phone (615) 994-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180521001777 TN Practitioner - Nurse Practitioner 2769747815

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
173987TNMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Volunteer Behavioral Health Care System CurrentSince Dec 28, 2017 Accepting new patients

Locations

413 Spring St
Chattanooga, TN 37405
Phone (423) 756-2740

2700 Executive Park NW
Cleveland, TN 37312
Phone (423) 479-9581

7200 Rhea County Hwy
Dayton, TN 37321
Phone (423) 570-0077

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/vbhcs/r4/

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": "1496880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1316476872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5511 VIRGINIA WAY",
            "address_2": "STE 300",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277611",
            "telephone_number": "615-994-1000",
            "fax_number": "615-994-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5511 VIRGINIA WAY",
            "address_2": "STE 300",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277611",
            "telephone_number": "615-994-1000",
            "fax_number": "615-994-0100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "249 Central Park Avenue",
            "address_2": "Ste 300-161",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234623099",
            "country_code": "US",
            "telephone_number": "615-994-1000",
            "fax_number": "615-994-0100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BREWER",
        "first_name": "BERNADETTE",
        "middle_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-08",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "23448",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "173987",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024190340",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, TN

Sources for this page

Verify at the official NPI Registry.