Individual provider Active NPI

Olivia Houchins, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Petersburg, VA
National Provider Identifier
1104452010
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0024179022 Issued in VA
Practice address
269 Medical Park Blvd
Petersburg, VA 23805-9337
Phone
(804) 861-0700
NPI assigned
Mar 23, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0024179022 VA Primary

Addresses

Primary practice location

269 Medical Park Blvd
Petersburg, VA 23805-9337

Mailing address

207 N 4TH Ave
Hopewell, VA 23860-2503
Phone (804) 541-0918

Other names 1

  • Olivia Mendoza Former name

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
I20200709002681 VA Practitioner - Nurse Practitioner 9436572468 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Virginia South Psychiatric and Family ServicesGroup PAC ID 3476443797, 35 clinicians

Practice addresses (Care Compare)

269 Medical Park Blvd
Petersburg, VA 23805-9337
Phone (804) 861-0700

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024179022VAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia South Psychiatric & Family Services CurrentSince Mar 18, 2020 Accepting new patients
Three Rivers Treatment Center LLC PastSince Mar 18, 2020 Accepting new patients

Locations

207 N 4th Ave
Hopewell, VA 23860
Phone (804) 518-6513

269 Medical Park Blvd
Petersburg, VA 23805
Phone (804) 861-0700

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.72142

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.

NPI Registry JSON

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

{
    "created_epoch": "1584921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1104452010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 N 4TH AVE",
            "city": "HOPEWELL",
            "state": "VA",
            "postal_code": "238602503",
            "telephone_number": "804-541-0918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "269 MEDICAL PARK BLVD",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238059337",
            "telephone_number": "804-861-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUCHINS",
        "first_name": "OLIVIA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-23",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024179022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OLIVIA",
            "last_name": "MENDOZA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Petersburg, VA

Sources for this page

Verify at the official NPI Registry.