Organization Active NPI

Bethany Health Services

  • Psychiatric/Mental Health Nurse Practitioner
  • West Lebanon, NH
National Provider Identifier
1780208686
Registry record updated Dec 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
BETHANY HEALTH SERVICES
Practice address
10 Benning St Ste 160 #208
West Lebanon, NH 03784-3402
Phone
(603) 601-4766
Fax
(603) 506-6362
NPI assigned
Jun 5, 2020
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Dr. Vannessa Davis, DNP, APRNNPI 1417373325
Title
NP
Phone
(603) 601-4766

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NH

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20220518001552 NH Part B Supplier - Clinic/Group Practice 9032596796 Receives reassigned benefits from 4 practitioners
Practice locations: Salem, NH

National Provider Directory

Locations

23 Stiles Rd
Ste 210
Salem, NH 03079
Phone (603) 601-4766

10 Benning St
Ste 160
West Lebanon, NH 03784
Phone (603) 601-4766

Specialties & licenses 5

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X
Clinic/Center 261Q00000X
Health Service Clinic/Center 261QH0100X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

NPPES NPI Registry

Primary practice location

10 Benning St Ste 160 #208
West Lebanon, NH 03784-3402

Mailing address

10 Benning St Ste 160
West Lebanon, NH 03784-3402
Phone (603) 601-4766

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 28, 2021.

{
    "created_epoch": "1591315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640649600000",
    "number": "1780208686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 BENNING ST STE 160",
            "city": "WEST LEBANON",
            "state": "NH",
            "postal_code": "037843402",
            "telephone_number": "603-601-4766",
            "fax_number": "603-506-6362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 BENNING ST STE 160 #208",
            "city": "WEST LEBANON",
            "state": "NH",
            "postal_code": "037843402",
            "telephone_number": "603-601-4766",
            "fax_number": "603-506-6362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHANY HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-05",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "VANNESSA",
        "authorized_official_title_or_position": "NP",
        "authorized_official_telephone_number": "603-601-4766",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, APRN"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Lebanon, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.