Individual provider Active NPI

Dustin Risser

  • Clinical Psychologist
  • Hampton, VA
National Provider Identifier
1124718135
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810008343 Issued in VA
Practice address
2202 Executive Dr Ste C
Hampton, VA 23666-6604
Phone
(757) 827-7707
NPI assigned
May 11, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 0810008343 VA Primary

Addresses

Primary practice location

2202 Executive Dr Ste C
Hampton, VA 23666-6604

Mailing address

2202 Executive Dr Ste C
Hampton, VA 23666-6604
Phone (757) 827-7707

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240329000017 VA Practitioner - Clinical Psychologist 8527406339 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Genesis Counseling Center, Inc.Group PAC ID 8729091715, 66 clinicians

Practice addresses (Care Compare)

638 Independence Pkwy
Suite 240
Chesapeake, VA 23320-5222
Phone (757) 965-5886

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Counseling Center, Inc. Clinical CurrentSince Nov 8, 2023 Accepting new patients

Locations

638 Independence Pkwy
Ste 240
Chesapeake, VA 23320
Phone (757) 609-3677

2208 Executive Dr
Hampton, VA 23666
Phone (757) 720-2210

2202 Executive Dr
Ste C
Hampton, VA 23666
Phone (757) 838-5055

6330 Newtown Rd
Ste 300
Norfolk, VA 23502
Phone (757) 466-3336

223 McLaws Cir
Williamsburg, VA 23185
Phone (757) 564-3100

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": "1683763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1124718135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2202 EXECUTIVE DR STE C",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236666604",
            "telephone_number": "757-827-7707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 EXECUTIVE DR STE C",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236666604",
            "telephone_number": "757-827-7707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RISSER",
        "first_name": "DUSTIN",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-11",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810008343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton, VA

Sources for this page

Verify at the official NPI Registry.