Active NPI
Bernadette Susanne Simme, MSN, APRN, BC
- Adult Psychiatric/Mental Health Clinical Nurse Specialist
- Raleigh, NC
National Provider Identifier
1770701054
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Psychiatric/Mental Health Clinical Nurse Specialist
- License
- 0352419
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6004016 | Medicaid | NC | |
| 87726 | Other | NC | UBH |
| 16412 | Other | NC | UBH |
| 130AY | Other | NC | BCBS |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 0352419-01 | NC | MD | Psychoanalyst |
| 0352419 | NC | MD | Adult 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2022; 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.