Individual provider Active NPI

Marlene Marie Adams, P.M.H.N.P.

  • Psychiatric/Mental Health Nurse Practitioner
  • Bassett, VA
National Provider Identifier
1598022592
Registry record updated Sep 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0024169958 Issued in VA
Practice address
324 T B Stanley Hwy
Bassett, VA 24055-6108
Phone
(276) 629-1076
NPI assigned
Apr 13, 2012
Last updated
Sep 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2022

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 0017140487 VA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0001194442 VA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0024169958 VA Primary

Addresses

Primary practice location

324 T B Stanley Hwy
Bassett, VA 24055-6108

Mailing address

130 Lakeside LN
Glade Hill, VA 24092-3980

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
I20120712000666 VA Practitioner - Nurse Practitioner 2668637877 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

130 Lakeside LN
Glade Hill, VA 24092-3980
Phone (540) 482-0204

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0001194442VAMDPsychiatric/Mental Health Nurse Practitioner
0017140487VAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Keep It Simple BH , PLLC Psychiatric/Mental Health CurrentSince Oct 1, 2022 Accepting new patients

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": "1334275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1598022592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 LAKESIDE LN",
            "city": "GLADE HILL",
            "state": "VA",
            "postal_code": "240923980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 T B STANLEY HWY",
            "city": "BASSETT",
            "state": "VA",
            "postal_code": "240556108",
            "telephone_number": "276-629-1076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "MARLENE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "P.M.H.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-13",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0017140487",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0001194442",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024169958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bassett, VA

Sources for this page

Verify at the official NPI Registry.