Individual provider Active NPI

Laurel Alexis Ambrose

  • Psychiatry Physician
  • Richmond, VA
National Provider Identifier
1104315910
Registry record updated Jan 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
0102205939 Issued in VA
Practice address
501 N 2ND St FL 3
Richmond, VA 23219-1359
Phone
(804) 828-9452
NPI assigned
May 7, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 0102205939 VA Primary

Addresses

Primary practice location

501 N 2ND St FL 3
Richmond, VA 23219-1359

Mailing address

PO Box 780125
Philadelphia, PA 19178-0125
Phone (804) 922-4844

Other practice location 1

1250 E Marshall St # 980257
Richmond, VA 23298-5051
Phone (804) 828-9783

Other practice location 2

1200 E Broad St
Richmond, VA 23298-5058
Phone (804) 828-9783

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
I20231121002323 VA Practitioner - Psychiatry 6305193830 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
MCV Associated PhysiciansGroup PAC ID 4385542117, 1,779 clinicians

Practice addresses (Care Compare)

501 N 2ND St
Richmond, VA 23219-1359
Phone (804) 828-9452

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.95 of 100Reported as group
Quality
69.91
Promoting interoperability
99
Improvement activities
40
Cost
77.42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
MCV Associated Physicians Psychiatry CurrentSince Oct 2, 2023 Accepting new patients
Virginia Commonwealth University Health System Authority PastSince Oct 2, 2023 Accepting new patients

Locations

501 N 2nd St
Richmond, VA 23219
Phone (804) 828-9452

501 N 2nd St
Fl 3
Richmond, VA 23219
Phone (804) 828-7912

1200 E Marshall St
Richmond, VA 23298
Phone (804) 827-0561

401 N 11th St
Richmond, VA 23219
Phone (804) 828-4409

1200 E Broad St
Richmond, VA 23298
Phone (804) 828-0970

1250 E Marshall St
Richmond, VA 23298
Phone (804) 628-6990

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1525651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1104315910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 780125",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191780125",
            "telephone_number": "804-922-4844",
            "fax_number": "804-327-3065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N 2ND ST FL 3",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232191359",
            "telephone_number": "804-828-9452"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1250 E Marshall St # 980257",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232985051",
            "country_code": "US",
            "telephone_number": "804-828-9783",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 E Broad St",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232985058",
            "country_code": "US",
            "telephone_number": "804-828-9783",
            "fax_number": "804-828-5613",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMBROSE",
        "first_name": "LAUREL",
        "middle_name": "ALEXIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-07",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0102205939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.