Individual provider Active NPI

Latasha Coett Matthews, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • North Chesterfield, VA
National Provider Identifier
1245018381
Registry record updated Sep 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0024188098 Issued in VA
Practice address
1000 Boulders Pkwy
North Chesterfield, VA 23225-5545
Phone
(804) 320-7881
NPI assigned
Sep 19, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2023

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 0024188098 VA Primary

Addresses

Primary practice location

1000 Boulders Pkwy
North Chesterfield, VA 23225-5545

Mailing address

1000 Boulders Pkwy
North Chesterfield, VA 23225-5545
Phone (804) 320-7881

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231229000241 VA Practitioner - Nurse Practitioner 8921458241 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tucker Psychiatric Clinic Inc.Group PAC ID 9133018922, 13 clinicians

Practice addresses (Care Compare)

1000 Boulders Pkwy
Suite 202
North Chesterfield, VA 23225-5515
Phone (804) 320-7881

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0024188098VAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tucker Psychiatric Clinic Inc. Psychiatric/Mental Health CurrentSince Dec 1, 2023 Accepting new patients

Locations

1000 Boulders Pkwy
Ste 202
North Chesterfield, VA 23225
Phone (804) 320-7881

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": "1695081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1245018381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 BOULDERS PKWY",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232255545",
            "telephone_number": "804-320-7881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 BOULDERS PKWY",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232255545",
            "telephone_number": "804-320-7881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTHEWS",
        "first_name": "LATASHA",
        "middle_name": "COETT",
        "name_prefix": "Mrs.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-19",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024188098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Chesterfield, VA

Sources for this page

Verify at the official NPI Registry.