Individual provider Active NPI

Cindy H Packer, CNS

  • Psychiatric/Mental Health Nurse Practitioner
  • Fishersville, VA
National Provider Identifier
1013981083
Registry record updated Sep 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0024165889 Issued in VA
Practice address
19 Briar Knoll CT
Ste 1
Fishersville, VA 22939-2635
Phone
(540) 949-0955
Fax
(540) 949-8377
NPI assigned
Feb 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Nurse Specialist 364S00000X 0024165889 VA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0024165889 VA Primary

Addresses

Primary practice location

19 Briar Knoll CT
Ste 1
Fishersville, VA 22939-2635

Mailing address

PO Box 4127
Roanoke, VA 24015-0127
Phone (940) 981-9394

Other identifiers 5

IdentifierTypeStateIssuer
085354MOtherVAOPTIMA BEHAVORIAL
172650OtherVAANTHEM BEHAVORIAL
5596863OtherVAFIRST HEALTH
010093317OtherVAVIRGINIA PREMIER
010093317MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist

State licenses

LicenseStateTypeSpecialty
0024165889VAMDClinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Shenandoah Psychiatric Medicine LLC PastSince Jan 1, 2013 Accepting new patients
Comprehensive Health Systems,PLC Psychiatric/Mental Health PastSince Jun 1, 2020 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379289600000",
    "number": "1013981083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4127",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240150127",
            "telephone_number": "940-981-9394",
            "fax_number": "540-344-7154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 BRIAR KNOLL CT",
            "address_2": "STE 1",
            "city": "FISHERSVILLE",
            "state": "VA",
            "postal_code": "229392635",
            "telephone_number": "540-949-0955",
            "fax_number": "540-949-8377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACKER",
        "first_name": "CINDY",
        "middle_name": "H",
        "credential": "CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-15",
        "last_updated": "2013-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "VA",
            "license": "0024165889",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024165889",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA BEHAVORIAL",
            "identifier": "085354M",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BEHAVORIAL",
            "identifier": "172650",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "5596863",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA PREMIER",
            "identifier": "010093317",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010093317",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishersville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.