BESPOKE PSYCHIATRY OF NORTHERN VIRGINIA
NPI 1104768878
Nurse Practitioner - Psychiatric/Mental Health in Alexandria, VA
About Bespoke Psychiatry Of Northern Virginia NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BESPOKE PSYCHIATRY OF NORTHERN VIRGINIA (NPI 1104768878) is a healthcare organization registered as a psychiatric/mental health in Alexandria, Virginia and active in the NPI registry since April 2026. The organization lists Jennifer Linda Jordan, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Bespoke Psychiatry Of Northern Virginia is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Bespoke Psychiatry Of Northern Virginia, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Bespoke Psychiatry Of Northern Virginia's NPI number?
The NPI number for Bespoke Psychiatry Of Northern Virginia is 1104768878. It was assigned to this organization in the NPPES registry on April 9, 2026.
Where is Bespoke Psychiatry Of Northern Virginia located?
Bespoke Psychiatry Of Northern Virginia is located at 1737 King St Ste 330, Alexandria, VA 22314. The listed phone number is (301) 642-5404.
What is Bespoke Psychiatry Of Northern Virginia's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Bespoke Psychiatry Of Northern Virginia enrolled in Medicare?
Yes. Bespoke Psychiatry Of Northern Virginia is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Bespoke Psychiatry Of Northern Virginia?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Bespoke Psychiatry Of Northern Virginia. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Bespoke Psychiatry Of Northern Virginia was last updated on April 25, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Bespoke Psychiatry Of Northern Virginia · NPI 1104768878
Psychiatric/Mental Health organization in Alexandria, Virginia. Organization record, active in the CMS NPPES registry since April 9, 2026.
## Identity
- **NPI:** 1104768878 (Entity type: Organization)
- **Enumerated:** April 9, 2026
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **Organization subpart:** No
- **Authorized official:** Jennifer Jordan, OWNER
## Practice location
- **Address:** 1737 KING ST STE 330, Alexandria, VA 22314-2760
- **Phone:** (301) 642-5404
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 25, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1104768878) · Data from the CMS NPPES public registry.