Individual provider Active NPI

Bernadette Susanne Simme, MSN, APRN, BC

  • Adult Psychiatric/Mental Health Clinical Nurse Specialist
  • Raleigh, NC
National Provider Identifier
1770701054
Registry record updated Mar 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X
License
0352419 Issued in NC
Practice address
1100 Logger CT Ste G100
Raleigh, NC 27609-8512
Phone
(919) 796-5771
Fax
(919) 596-3458
NPI assigned
Apr 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 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 Clinical Nurse Specialist 364SP0808X 0352419 NC
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X 0352419 NC Primary
Psychoanalyst 102L00000X 0352419-01 NC

Addresses

Primary practice location

1100 Logger CT Ste G100
Raleigh, NC 27609-8512

Mailing address

1100-G100 Logger Court
Raleigh, NC 27609-8512
Phone (919) 796-5771

Other identifiers 4

IdentifierTypeStateIssuer
6004016MedicaidNC
87726OtherNCUBH
16412OtherNCUBH
130AYOtherNCBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20040721000367 NC Practitioner - Certified Clinical Nurse Specialist (CNS) 2961482013 Practice locations: Raleigh, NC

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Brody School of Medicine at East Carolina University, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1100 Logger CT
G100
Raleigh, NC 27609-8512
Phone (919) 796-5771

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
0352419-01NCMDPsychoanalyst
0352419NCMDAdult Psychiatric/Mental Health Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1770701054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100-G100 LOGGER COURT",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276098512",
            "telephone_number": "919-796-5771",
            "fax_number": "919-596-3458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 LOGGER CT STE G100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276098512",
            "telephone_number": "919-796-5771",
            "fax_number": "919-596-3458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMME",
        "first_name": "BERNADETTE",
        "middle_name": "SUSANNE",
        "credential": "MSN, APRN, BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2022-03-07",
        "certification_date": "2022-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "NC",
            "license": "0352419",
            "primary": false
        },
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "NC",
            "license": "0352419",
            "primary": true
        },
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": "NC",
            "license": "0352419-01",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6004016",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH",
            "identifier": "87726",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH",
            "identifier": "16412",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "130AY",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.