Javier Jimill Way, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

0024182964 Issued in VA

Practice address

780 Lynnhaven Pkwy
Virginia Beach, VA 23452-7332

Phone

(984) 283-2136

Fax

(434) 509-1721

NPI assigned

Oct 21, 2021

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1634774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1114680592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 E LITTLE CREEK RD STE 205",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235184137",
            "telephone_number": "757-587-4744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 LYNNHAVEN PKWY",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234527332",
            "telephone_number": "984-283-2136",
            "fax_number": "434-509-1721"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 E Little Creek Rd Ste 205",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235184137",
            "country_code": "US",
            "telephone_number": "757-587-4744",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAY",
        "first_name": "JAVIER",
        "middle_name": "JIMILL",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-21",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024182964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 Apr 20, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.