Johanna Verburg, DNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

107770 Issued in WV

Practice address

14 Wine Dr
Fairmont, WV 26554-2676

Phone

(681) 404-0211

NPI assigned

Dec 15, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Johanna Overstreet Former name

Medicare fee-for-service enrollment

Enrolled in WV

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Chesapeake Healthcare CenterGroup PAC ID 5496090037, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Chesapeake Healthcare Center

  • Clinic/Center
  • Chesapeake, WV
  • NPI 1790279651

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Everyday People Inc

  • Podiatrist
  • Decatur, AL
  • NPI 1205720877

  Single Specialty

  NPD

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

{
    "created_epoch": "1481760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1780128439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 WINE DR",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265542676",
            "telephone_number": "681-404-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 WINE DR",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265542676",
            "telephone_number": "681-404-0211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "129 Deanna Street",
            "address_purpose": "LOCATION",
            "city": "Comfort",
            "state": "WV",
            "postal_code": "25049",
            "country_code": "US",
            "telephone_number": "304-381-6659",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VERBURG",
        "first_name": "JOHANNA",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-15",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-144007",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WV",
            "license": "107770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHANNA",
            "last_name": "OVERSTREET",
            "credential": "FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Julia B Vanvolkenburg, MED/CCC-SLP
• Shannon Jo Vasconcellos
• John Vash, H.I.S.
• Richard E Vasicek, DO
• Aaron M. Vedock, MSW
• Matthew Francis Verona, D.O.
• Michael Ray Vice
• Ryan Vilain
• Jenna Anne Vincent
• Mason Vincent

• Psychiatric/Mental Health Nurse Practitioner in Fairmont, WV
• Providers in Fairmont, WV by specialty
• Psychiatric/Mental Health Nurse Practitioner in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; 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.