DR. BONITA MARIE JACKSON-VERGARA LICENSED COUNSELOR
NPI 1316967334
Counselor - Professional in Chesapeake, VA
About Dr. Bonita Marie Jackson-vergara Licensed Counselor NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. BONITA MARIE JACKSON-VERGARA LICENSED COUNSELOR (NPI 1316967334) is an individual professional provider in Chesapeake, Virginia, licensed in North Carolina (4804) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Locations 2
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Bonita Marie Jackson-vergara Licensed Counselor is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Bonita Jackson-vergara reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Waldorf, MD 20603
- Reassigned Medicare billing, Virginia and District of Columbia enrollments
- Also billed through NPI 1952320061 (District of Columbia)
- 2,379 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
CHESAPEAKE, VA 23320
CHESAPEAKE, VA 23320
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 Bonita Jackson-vergara's NPI number?
The NPI number for Bonita Jackson-vergara is 1316967334. It was assigned to this individual provider in the NPPES registry on July 20, 2006.
Where is Bonita Jackson-vergara located?
Bonita Jackson-vergara practices at 1545 Crossways Blvd Ste 250, Chesapeake, VA 23320. The listed phone number is (704) 804-9614.
What is Bonita Jackson-vergara's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Bonita Jackson-vergara enrolled in Medicare?
Yes. Bonita Jackson-vergara is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Bonita Jackson-vergara's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Bonita Jackson-vergara reassigns Medicare benefits to Inova Health Care Services (Waldorf, MD). The 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 Bonita Jackson-vergara's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Bonita Jackson-vergara was last updated on October 13, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.
# Dr. Bonita Marie Jackson-Vergara, LICENSED COUNSELOR · NPI 1316967334
Professional provider in Chesapeake, Virginia. Individual provider, active in the CMS NPPES registry since July 20, 2006.
## Identity
- **NPI:** 1316967334 (Entity type: Individual)
- **Enumerated:** July 20, 2006
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** 4804 (North Carolina)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1545 CROSSWAYS BLVD STE 250, Chesapeake, VA 23320-0218
- **Phone:** (704) 804-9614
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Inova Health Care Services (NPI 1851829550, Waldorf, MD), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 13, 2021
- **Other identifiers:** Medicaid 6103317 (NC)
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Source: [NPI Profile](https://npiprofile.com/npi/1316967334) · Data from the CMS NPPES public registry.