Individual provider Active NPI

Priscilla A Timoh, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Richmond, TX
National Provider Identifier
1043554991
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1061201 Issued in TX
Practice address
7023 Tallow Knoll LN
Richmond, TX 77407-7843
Phone
(240) 547-8312
NPI assigned
Nov 15, 2012
Last updated
Oct 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1061201 TX Primary
Home Health Aide 374U00000X NU

Addresses

Primary practice location

7023 Tallow Knoll LN
Richmond, TX 77407-7843

Mailing address

7023 Tallow Knoll LN
Richmond, TX 77407-7843
Phone (240) 547-8312

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220919001752 TX Practitioner - Nurse Practitioner 0648605816 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Progressive Behavioral Health, PLLCGroup PAC ID 4486794906, 366 clinicians

Practice addresses (Care Compare)

2222 W Spring Creek Pkwy
Suite 116
Plano, TX 75023-4508
Phone (844) 824-8775

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Primic Palliative Hospice Care Inc CurrentSince Aug 25, 2022 Accepting new patients
A & S Hospice and Palliative Care LLC Current Accepting new patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Jul 18, 2023 Accepting new patients
Wah Psychiatrist PLLC Psychiatric/Mental Health CurrentSince Apr 14, 2023 Accepting new patients
Progressive Behavioral Health, PLLC Psychiatric/Mental Health CurrentSince Jun 1, 2024 Accepting new patients
Mava Healthcare System LLC CurrentSince Jun 1, 2023 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

12505 Memorial Dr
Ste 230
Houston, TX 77024
Phone (210) 858-9078

700 Milam St
Ste 1300
Houston, TX 77002
Phone (281) 801-8391

23051 Kingwood Place Dr
Ste 110
Kingwood, TX 77339
Phone (281) 374-4500

18230 FM 1488 Rd
Ste 201
Magnolia, TX 77354
Phone (832) 810-0200

2222 W Spring Creek Pkwy
Ste 116
Plano, TX 75023
Phone (972) 964-3214

25319 Interstate 45
Ste 100
Spring, TX 77380
Phone (832) 810-0200

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.priscilliaomoleme@136732.advancedmd-direct.com

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Always Here Hospice and Palliative Care LLCHouston, TX, CCN 971724 Hospice Corporate Director
W-2 Managing Employee
Mar 17, 2023
Mar 17, 2023
Primic Palliative Hospice Care IncHouston, TX, CCN A91776 Hospice 5% Or Greater Direct Ownership Interest (100%)
Corporate Officer
W-2 Managing Employee
Aug 25, 2022
Aug 25, 2022
Aug 25, 2022

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1043554991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7023 TALLOW KNOLL LN",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774077843",
            "telephone_number": "240-547-8312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7023 TALLOW KNOLL LN",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774077843",
            "telephone_number": "240-547-8312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIMOH",
        "first_name": "PRISCILLA",
        "middle_name": "A",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-15",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1061201",
            "primary": true
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, TX

Sources for this page

Verify at the official NPI Registry.