Individual provider Active NPI

Rajpati Bodh-Ceres, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Waynesboro, TN
National Provider Identifier
1902204480
Registry record updated Jan 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
21248 Issued in TN
Practice address
209 S High St
Waynesboro, TN 38485-2605
Phone
(228) 865-1330
NPI assigned
Dec 15, 2014
Last updated
Jan 31, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 21248 TN Primary

Addresses

Primary practice location

209 S High St
Waynesboro, TN 38485-2605

Mailing address

418 Main Street
Waynesboro, TN 38384-6003
Phone (731) 727-8012

Other practice location 1

418 S Main St
Waynesboro, TN 38485-2629
Phone (731) 727-8012

Other identifiers 1

IdentifierTypeStateIssuer
461899OtherNYRN LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20170117000985 TN Practitioner - Nurse Practitioner 0446532097 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

209 S High St
Waynesboro, TN 38485-2605
Phone (931) 676-7249

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Agape Mental Health Center Inc Psychiatric/Mental Health CurrentSince Jan 1, 2023 Accepting new patients
Medi-Serv. Inc. PastSince Feb 8, 2023 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1418601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675123200000",
    "number": "1902204480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 MAIN STREET",
            "city": "WAYNESBORO",
            "state": "TN",
            "postal_code": "383846003",
            "telephone_number": "731-727-8012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 S HIGH ST",
            "city": "WAYNESBORO",
            "state": "TN",
            "postal_code": "384852605",
            "telephone_number": "228-865-1330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "418 S Main St",
            "address_purpose": "LOCATION",
            "city": "Waynesboro",
            "state": "TN",
            "postal_code": "384852629",
            "country_code": "US",
            "telephone_number": "731-727-8012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BODH-CERES",
        "first_name": "RAJPATI",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-15",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "21248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "461899",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waynesboro, TN

Sources for this page

Verify at the official NPI Registry.