Henrietta Bannerman

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

26NJ14928000 Issued in NJ

Practice address

2 University PLZ
Hackensack, NJ 07601-6202

Phone

(212) 203-1773

Fax

(646) 665-4427

NPI assigned

Dec 27, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Middlesex Psychiatry & TMS PC

  dba Reservoir Health

  • Psychiatry Physician
  • Fairfield, NJ
  • NPI 1053971572

  Single Specialty

  Medicare reassignment NPD
• Rivia Medical PLLC

  dba RIVIA Mind

  • Nutritionist
  • New York, NY
  • NPI 1871280818
  NPD

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

{
    "created_epoch": "1388102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1477974095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "274 MADISON AVE RM 1501",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100160701",
            "telephone_number": "212-203-1773",
            "fax_number": "646-665-4427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 UNIVERSITY PLZ",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076016202",
            "telephone_number": "212-203-1773",
            "fax_number": "646-665-4427"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "274 Madison Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100160701",
            "country_code": "US",
            "telephone_number": "212-203-1773",
            "fax_number": "646-665-4427",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANNERMAN",
        "first_name": "HENRIETTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-27",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "678130",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR20490500",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "405453",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ14928000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bami Dental Inc. (Bami Dental Center)
• Heather A Bamond, PA
• Nicole Banales, LSW
• Janelle Bang, PT, DPT
• Teresa Sharlene Bittol Bangwa
• Jerry Michael Baratta, D.O.
• Barbara a Cavallaro, MD PC
• Susan Barbara, RN HEALTH EDUCATOR
• Barbieri, Colameo & Berardo, Associates in Oral and Maxillofacial Surg
• Yonatan Bardash, MD

• Psychiatric/Mental Health Nurse Practitioner in Hackensack, NJ
• Providers in Hackensack, NJ by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.