Organization Active NPI

Bespoke Psychiatric, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Lincoln, NE
National Provider Identifier
1790565232
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
BESPOKE PSYCHIATRIC, LLC
Practice address
6016 S 87TH St Ste 120
Lincoln, NE 68526-9364
Phone
(531) 242-6965
Fax
(531) 242-5285
NPI assigned
Oct 2, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

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

Authorized official

Name
Paige E BureshNPI 1124750559
Title
Co-Owner
Phone
(531) 242-6965

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

6016 S 87TH St Ste 120
Lincoln, NE 68526-9364

Mailing address

6016 S 87TH St Ste 120
Lincoln, NE 68526-9364

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1696204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733788800000",
    "number": "1790565232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6016 S 87TH ST STE 120",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685269364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6016 S 87TH ST STE 120",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685269364",
            "telephone_number": "531-242-6965",
            "fax_number": "531-242-5285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BESPOKE PSYCHIATRIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-02",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A",
        "authorized_official_last_name": "BURESH",
        "authorized_official_first_name": "PAIGE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "531-242-6965"
    },
    "taxonomies": [
        {
            "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 Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.