Organization Active NPI

Minds That Matter LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Chesapeake, VA
National Provider Identifier
1124883434
Registry record updated Feb 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
MINDS THAT MATTER LLC
Practice address
808 Eden Way N
Chesapeake, VA 23320-0745
Phone
(757) 354-3161
NPI assigned
Feb 15, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2024

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

Authorized official

Name
Stacie Anita PittmanNPI 1144899592
Title
Pmhnp-BC
Phone
(757) 531-6485

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

808 Eden Way N
Chesapeake, VA 23320-0745

Mailing address

1580 Crystal Lake Dr
Portsmouth, VA 23701-3624
Phone (757) 531-6485

Other names 1

  • n/a Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240807001409 VA Part B Supplier - Clinic/Group Practice 0345787420 Receives reassigned benefits from 1 practitioner
Practice locations: Chesapeake, VA

National Provider Directory

National Provider Directory

Locations

808 Eden Way N
Chesapeake, VA 23320
Phone (757) 354-3161

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1707955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707955200000",
    "number": "1124883434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 CRYSTAL LAKE DR",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237013624",
            "telephone_number": "757-531-6485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 EDEN WAY N",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233200745",
            "telephone_number": "757-354-3161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDS THAT MATTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-15",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A",
        "authorized_official_last_name": "PITTMAN",
        "authorized_official_first_name": "STACIE",
        "authorized_official_middle_name": "ANITA",
        "authorized_official_title_or_position": "PMHNP-BC",
        "authorized_official_telephone_number": "757-531-6485"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "n/a",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chesapeake, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.