Individual provider Active NPI

Jamie A Holland, PMHNP-BC, AGCNS-BCRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Virginia Beach, VA
National Provider Identifier
1033876990
Registry record updated Feb 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0024181879 Issued in VA
Practice address
3149 Shore Dr Ste C
Virginia Beach, VA 23451-1129
Phone
(757) 291-4876
NPI assigned
Nov 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2022

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 0024181879 VA Primary

Addresses

Primary practice location

3149 Shore Dr Ste C
Virginia Beach, VA 23451-1129

Mailing address

3149 Shore Dr Ste C
Virginia Beach, VA 23451-1129
Phone (757) 291-4876

Other practice location 1

1000 Regent University Drive
CRB 129
Virginia Beach, VA 23464-5037
Phone (757) 291-4876

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0024181879VAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Coast to Coast Counseling & Wellness, LLC Psychiatric/Mental Health CurrentSince Nov 28, 2021 Accepting new patients

Locations

1000 Regent University Dr
#129
Virginia Beach, VA 23464
Phone (757) 291-4876

3149 Shore Dr
Ste C
Virginia Beach, VA 23451
Phone (757) 291-4258

Organizations & group practices 1

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": "1637798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643846400000",
    "number": "1033876990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3149 SHORE DR STE C",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234511129",
            "telephone_number": "757-291-4876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3149 SHORE DR STE C",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234511129",
            "telephone_number": "757-291-4876"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Regent University Drive",
            "address_2": "CRB 129",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234645037",
            "country_code": "US",
            "telephone_number": "757-291-4876",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLLAND",
        "first_name": "JAMIE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PMHNP-BC, AGCNS-BCRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-25",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024181879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2022; 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.