Emily-Rose Montgomery Virden

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

2292320 Issued in MA

Practice address

331 West Grove Street
Ste 4
Middleboro, MA 02346-0234

Phone

(857) 330-6565

Fax

(857) 330-6566

NPI assigned

Sep 3, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MA, NY2 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

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

MCCD FL Psychiatry Services PAGroup PAC ID 4880064070, 751 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• MCCD FL Psychiatry Services PA

  • Psychiatry Physician
  • Jacksonville, FL
  • NPI 1659003457

  MA

  Medicare reassignment Care Compare group NPD
• MCCD Psychiatry Services PLLC

  • Psychiatry Physician
  • New York, NY
  • NPI 1033750823
  Medicare reassignment

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

{
    "created_epoch": "1441238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1194193441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 WEST GROVE STREET",
            "address_2": "STE 4",
            "city": "MIDDLEBORO",
            "state": "MA",
            "postal_code": "023465230",
            "telephone_number": "857-330-6565",
            "fax_number": "857-330-6566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 WEST GROVE STREET",
            "address_2": "STE 4",
            "city": "MIDDLEBORO",
            "state": "MA",
            "postal_code": "023460234",
            "telephone_number": "857-330-6565",
            "fax_number": "857-330-6566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIRDEN",
        "first_name": "EMILY-ROSE",
        "middle_name": "MONTGOMERY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-03",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "2292320",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "2292320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victory Distributors LLC
• Victory Distributors, Inc.
• Hailey Rose Viera
• Breanne Nicole Vigeant
• Micaela Violette, LICSW
• Visitingdental Associates of Ma LLC
• Raquel F.R. Volney, MD
• Ronald Albert Volney, MD
• Walgreen Co
• Frank R Walsh, DMD

• Psychiatric/Mental Health Nurse Practitioner in Middleboro, MA
• Providers in Middleboro, MA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.