Individual provider Active NPI

Joshua Niekranz, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Reston, VA
National Provider Identifier
1396407227
Registry record updated Sep 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0024182814 Issued in VA
Practice address
12359 Sunrise Valley Dr Ste 320
Reston, VA 20191-3463
Phone
(703) 596-4796
NPI assigned
Oct 7, 2021
Last updated
Sep 6, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2022

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 0024182814 VA Primary

Addresses

Primary practice location

12359 Sunrise Valley Dr Ste 320
Reston, VA 20191-3463

Mailing address

12359 Sunrise Valley Dr Ste 320
Reston, VA 20191-3463
Phone (619) 363-2055

Other practice location 1

6565 Arlington Blvd Ste 405
Falls Church, VA 22042-3013
Phone (703) 596-4796

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20211230001006 DC Practitioner - Nurse Practitioner 9234520222 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
My Psychiatrist, LLCGroup PAC ID 5597898981, 15 clinicians

Practice addresses (Care Compare)

12359 Sunrise Valley Dr
Suite 320
Reston, VA 20191-3463
Phone (703) 596-4796

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024182814VAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
My Psychiatrist LLC CurrentSince Nov 29, 2021 Accepting new patients

Locations

6565 Arlington Blvd
Ste 405
Falls Church, VA 22042
Phone (571) 946-2189

12359 Sunrise Valley Dr
#32
Reston, VA 20191
Phone (703) 596-4796

12359 Sunrise Valley Dr
Ste 320
Reston, VA 20191
Phone (703) 596-4796

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, 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": "1633564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1396407227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12359 SUNRISE VALLEY DR STE 320",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201913463",
            "telephone_number": "619-363-2055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12359 SUNRISE VALLEY DR STE 320",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201913463",
            "telephone_number": "703-596-4796"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6565 Arlington Blvd Ste 405",
            "address_purpose": "LOCATION",
            "city": "Falls Church",
            "state": "VA",
            "postal_code": "220423013",
            "country_code": "US",
            "telephone_number": "703-596-4796",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIEKRANZ",
        "first_name": "JOSHUA",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-07",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024182814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

Verify at the official NPI Registry.