Individual provider Active NPI

Ekaterina Wood, FNP-C. PMHNP

  • Nurse Practitioner
  • Winchester, VA
National Provider Identifier
1083198170
Registry record updated Oct 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0024176647 Issued in VA
Practice address
36 Ricketts Dr
Winchester, VA 22601-3676
Phone
(540) 535-1112
NPI assigned
Sep 24, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0024176647 VA Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0024176647 VA

Addresses

Primary practice location

36 Ricketts Dr
Winchester, VA 22601-3676

Mailing address

36 Ricketts Dr
Winchester, VA 22601-3676
Phone (540) 535-1112

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230731000385 VA Practitioner - Psychiatry 5395080030 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Winchester Community Mental Health Center, Inc.Group PAC ID 9032249214, 13 clinicians

Practice addresses (Care Compare)

36 Ricketts Dr
Winchester, VA 22601-3676
Phone (540) 535-1112

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024176647VAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Winchester Community Mental Health Center, Inc. Nurse Practitioner CurrentSince May 10, 2023 Accepting new patients

Locations

105 Stony Pointe Way
Ste 210
Strasburg, VA 22657
Phone (540) 465-9606

36 Ricketts Dr
Winchester, VA 22601
Phone (540) 535-1112

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": "1537747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729987200000",
    "number": "1083198170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 RICKETTS DR",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226013676",
            "telephone_number": "540-535-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 RICKETTS DR",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226013676",
            "telephone_number": "540-535-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "EKATERINA",
        "credential": "FNP-C. PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-24",
        "last_updated": "2024-10-27",
        "certification_date": "2024-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024176647",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024176647",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, VA

Sources for this page

Verify at the official NPI Registry.