Heidi Anna Cook, MA, MSN,PMHNP-BC

Key facts

NPI: 1831769231
Entity type: Individual (NPI type 1)
Primary specialty: Psychiatric/Mental Health Nurse Practitioner 363LP0808X
License: 0024181691 (VA)
Practice address: 12359 Sunrise Valley Dr Ste 320
Reston, VA 20191-3463
Phone: (703) 596-4796
Fax: (703) 787-8210
NPI assigned: Jun 28, 2021
Sex: Female
Sole proprietor: No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

My Psychiatrist LLC Mental Health Clinic/Center (Including Community Mental Health Center) · Reston, VA · NPI 1295048684

Medicare reassignment Care Compare group NPD DC

Medicare Care Compare profile

Specialty: Nurse Practitioner
Education: Other, 2021
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Telehealth: Offers telehealth services
Group practices: My Psychiatrist, LLC (15 clinicians)

Practice addresses (Care Compare)

12359 Sunrise Valley Dr
Suite 320
Reston, VA 20191-3463
Phone (703) 596-4796

Medicare participation

Medicare fee-for-service enrollment: Enrolled in DC
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20221006001113	DC	Practitioner - Nurse Practitioner	5395121842	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Master of Arts, Master of Science - Nursing, Nurse Practitioner

State licenses

License	State	Type	Specialty
0024181691	VA	MD	Psychiatric/Mental Health Nurse Practitioner

Practice roles

Organization	Specialty	Status	New patients
My Psychiatrist LLC		Current since Sep 1, 2022	Accepting new patients

Locations

12359 Sunrise Valley Dr
Ste 320
Reston, VA 20191
Phone (703) 596-4796

12359 Sunrise Valley Dr
#32
Reston, VA 20191
Phone (703) 596-4796

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Psychiatric/Mental Health Nurse Practitioner	363LP0808X	0024181691	VA	Yes

Addresses

Primary practice location

12359 Sunrise Valley Dr Ste 320
Reston, VA 20191-3463

Mailing address

12359 Sunrise Valley Dr Ste 320
Reston, VA 20191-3463
Phone (703) 596-4797

Electronic endpoints

Type	Endpoint	Use	Affiliation
CONNECT URL	mypsych.com

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 9, 2022.

{
    "created_epoch": "1624838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662681600000",
    "number": "1831769231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12359 SUNRISE VALLEY DR STE 320",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201913463",
            "telephone_number": "703-596-4797",
            "fax_number": "703-787-8210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12359 SUNRISE VALLEY DR STE 320",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201913463",
            "telephone_number": "703-596-4796",
            "fax_number": "703-787-8210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "HEIDI",
        "middle_name": "ANNA",
        "name_prefix": "Mrs.",
        "credential": "MA, MSN,PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-28",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024181691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "mypsych.com",
            "affiliation": "N",
            "address_1": "12359 Sunrise Valley Dr Ste 320",
            "city": "Reston",
            "state": "VA",
            "country_code": "US",
            "postal_code": "201913463",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Reston, VA

All providers in Reston, VA · Psychiatric/Mental Health Nurse Practitioner in Virginia

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 9, 2022. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
Medicare Care Compare provider data (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.