Individual provider Active NPI

Ivana Spencer

  • Psychiatric/Mental Health Nurse Practitioner
  • Richmond, VA
National Provider Identifier
1063204469
Registry record updated Dec 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0024194447 Issued in VA
Practice address
1601 Willow Lawn Dr Ste 304
The Shops at Willow Lawn #1283
Richmond, VA 23230-3423
Phone
(804) 825-2308
Fax
(804) 964-9870
NPI assigned
May 21, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2025

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 0024194447 VA Primary
Registered Nurse 163W00000X 0001284498 VA

Addresses

Primary practice location

1601 Willow Lawn Dr Ste 304
The Shops at Willow Lawn #1283
Richmond, VA 23230-3423

Mailing address

1601 Willow Lawn Dr
Ste. 304, the Shops at Willow Lawn #1283
Richmond, VA 23230-3427
Phone (757) 793-9483

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20251118002794 VA Practitioner - Nurse Practitioner 5991296816 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1801 S Church St
Suite 4
Smithfield, VA 23430-1858

7108 Evelyn T Butts Ave
Norfolk, VA 23513-1817

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0001284498VAMDRegistered Nurse
0024194447VAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Focused Psychiatric and Mental Health Care Services, LLC Psychiatric/Mental Health CurrentSince Oct 1, 2025 Accepting new patients
Groundedsis Current Accepting new patients
Hull Physical Therapy, LLC PastSince Aug 25, 2020 Accepting new patients

Locations

1601 Willow Lawn Dr
Ste 304
Richmond, VA 23230
Phone (804) 381-4783

1801 S Church St
Ste 2
Smithfield, VA 23430
Phone (757) 509-1725

1801 S Church St
Ste 4
Smithfield, VA 23430
Phone (757) 793-9483

Organizations & group practices 3

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": "1747785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764806400000",
    "number": "1063204469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 WILLOW LAWN DR",
            "address_2": "STE. 304, THE SHOPS AT WILLOW LAWN #1283",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232303427",
            "telephone_number": "757-793-9483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 WILLOW LAWN DR STE 304",
            "address_2": "THE SHOPS AT WILLOW LAWN #1283",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232303423",
            "telephone_number": "804-825-2308",
            "fax_number": "804-964-9870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "IVANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-21",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024194447",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001284498",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.