Individual provider Active NPI

Donatien Ndoungwa Ntennou, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Chesapeake, VA
National Provider Identifier
1124853171
Registry record updated Sep 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0024191144 Issued in VA
Practice address
638 Independence Pkwy Ste 240
Chesapeake, VA 23320-5222
Phone
(757) 965-5886
NPI assigned
Sep 6, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2024

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 0024191144 VA Primary

Addresses

Primary practice location

638 Independence Pkwy Ste 240
Chesapeake, VA 23320-5222

Mailing address

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241211004747 VA Practitioner - Nurse Practitioner 1153857289 Reassigns benefits to 2 organizations
I20260319003844 DC Practitioner - Nurse Practitioner 1153857289 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2252 Sanibel LN
Chesapeake, VA 23321-1448

831 Bedford Ave
Suite 530
Brooklyn, NY 11205-2801

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rhodium Care Group Inc CurrentSince Sep 7, 2024 Accepting new patients
Destiny Helpers Psychiatric Associates LLC Psychiatric/Mental Health CurrentSince Nov 1, 2025 Accepting new patients

Locations

8830 Virginia St
Amelia Ct Hse, VA 23002
Phone (804) 561-5611

700 Tech Center Pkwy
Ste 20090
Newport News, VA 23606
Phone (757) 826-0346

7320 Warwick Blvd
Newport News, VA 23607
Phone (757) 244-7901

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": "1725580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1124853171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "638 INDEPENDENCE PKWY STE 240",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233205222",
            "telephone_number": "757-965-5886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "638 INDEPENDENCE PKWY STE 240",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233205222",
            "telephone_number": "757-965-5886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NTENNOU",
        "first_name": "DONATIEN",
        "middle_name": "NDOUNGWA",
        "name_prefix": "Mr.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-06",
        "last_updated": "2024-09-06",
        "certification_date": "2024-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024191144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

Verify at the official NPI Registry.