Benita C Bocanegra
Individual provider Active NPI Acute Care Nurse Practitioner · Hardy, VA
NPI 1962029827 · NPPES record last updated Nov 9, 2021
Key facts
- NPI
- 1962029827
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Acute Care Nurse Practitioner 363LA2100X
- License
- 0024179521 (VA)
- Practice address
- 1424 Old Station Loop
Hardy, VA 24101-3600 - Phone
- (540) 765-7718
- NPI assigned
- Jun 26, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Old Mission Wound Care Virginia PLLC
Friendship Physician Clinic Inc
Provider Partners Care Management LP
Practice addresses (Care Compare)
1545 Crossways Blvd
Suite 250
Chesapeake, VA 23320-0218
Phone (231) 333-4388
391 Hershberger Rd
Roanoke, VA 24012-1983
Phone (540) 265-2087
46531 Leesburg Pike
Sterling, VA 20164-3555
Phone (703) 834-5800
Hospital & facility affiliations
- Enhabit Home Health (Roanoke)
- Carilion Home Care Services - Roanoke
- Carilion Home Care Franklin
- Carilion Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- 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 |
|---|---|---|---|---|
| I20210726003060 | VA | Practitioner - Nurse Practitioner | 6406259613 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0024179521 | VA | MD | Acute Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blue Ridge Behavioral Healthcare | Current |
Accepting new patients | |
| Old Mission Wound Care Virginia PLLC | Current |
Accepting new patients | |
| Dr Edward a Bauchou Jr DC PC | Current |
Accepting new patients | |
| Provider Partners Care Management LP | Current |
Accepting new patients | |
| Friendship Physician Clinic Inc | Current |
Accepting new patients |
Locations
8820 Columbia 100 Pkwy
Ste 430
Columbia, MD 21045
Phone (410) 967-2097
225 Matlage Way
Unit 31
Sugar Land, TX 77487
1545 Crossways Blvd
Ste 250
Chesapeake, VA 23320
Phone (757) 206-2772
7724 Timberlake Rd
Lynchburg, VA 24502
Phone (434) 237-4831
8401 Mayland Dr
Ste V
Richmond, VA 23294
Phone (910) 803-3633
5647 Starkey Rd
Roanoke, VA 24018
Phone (540) 265-8097
391 Hershberger Rd
Roanoke, VA 24012
Phone (540) 265-2087
301 Elm Ave SW
Roanoke, VA 24016
Phone (540) 266-9200
3719 Knollridge Rd
Salem, VA 24153
Phone (540) 265-2087
46531 Leesburg Pike
Sterling, VA 20164
Phone (703) 834-5800
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | 0024179521 | VA | Yes |
Addresses
Primary practice location
1424 Old Station Loop
Hardy, VA 24101-3600
Mailing address
1424 Old Station Loop
Hardy, VA 24101-3600
Phone (540) 765-7718
Other providers in Hardy, VA
- Robert Amick
- Sarah Baldwin
- Kristen Bane
- Blue Ridge Hearing Group
- Blue Ridge Optical
- Brags Consulting LLC
- Brigette Funk LLC
- Margaret Westray Campbell
- Carilion Giles Community Hospital
- Carilion Healthcare Corporation
All providers in Hardy, VA · Acute Care 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 Nov 9, 2021. 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.