Melita Claresa Wilson- Primus, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

0024186275 Issued in VA

Practice address

508 S Independence Blvd # 200202
Virginia Beach, VA 23452-1178

Phone

(757) 490-6463

Fax

(757) 930-6464

NPI assigned

Jan 31, 2023

Reactivated

Jun 5, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Transformation Health Services LLCGroup PAC ID 2567795628, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Shining Star Psychiatric Care LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Richmond, VA
  • NPI 1053149211

  Single Specialty

  Medicare reassignment NPD Authorized official
• Transformation Health Services LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Virginia Beach, VA
  • NPI 1508373812

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Transformation Health Services LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Virginia Beach, VA
  • NPI 1013844893
  NPD (past)

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

{
    "created_epoch": "1675123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1063118123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 POPLAR DR",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238059367",
            "telephone_number": "866-546-2229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 S INDEPENDENCE BLVD # 200202",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234521178",
            "telephone_number": "757-490-6463",
            "fax_number": "757-930-6464"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 Poplar Dr",
            "address_purpose": "LOCATION",
            "city": "Petersburg",
            "state": "VA",
            "postal_code": "238059367",
            "country_code": "US",
            "telephone_number": "866-546-2229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON- PRIMUS",
        "first_name": "MELITA",
        "middle_name": "CLARESA",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-31",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "deactivation_date": "2024-05-13",
        "reactivation_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024186275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Ann Wills, PHD
• Raneshia Wills
• Tyana Wills
• Willview Behavioral LLC.
• Janet Leigh Wilms, RPH, MBA
• Camille Wilson-Howell, RBT
• Adalay M Wilson, LCSW
• Adrienne Denise Wilson
• Aiyana Noelle Wilson
• Alexandra Wilson

• Psychiatric/Mental Health Nurse Practitioner in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.