Individual provider Active NPI

Tonjanika Ballard, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Richmond, VA
National Provider Identifier
1255717088
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0024172800 Issued in VA
Practice address
4901 Fitzhugh Ave Ste 200
Richmond, VA 23230-3531
Phone
(804) 464-8340
Fax
(804) 884-3726
NPI assigned
Aug 4, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 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 0024172800 VA Primary

Addresses

Primary practice location

4901 Fitzhugh Ave Ste 200
Richmond, VA 23230-3531

Mailing address

4901 Fitzhugh Ave Ste 200
Richmond, VA 23230-3531
Phone (804) 464-8340

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
I20160321001060 VA Practitioner - Nurse Practitioner 3476869348 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Unique Holistic Care LLCGroup PAC ID 5991084980, 8 clinicians

Practice addresses (Care Compare)

4901 Fitzhugh Ave
Suite 200
Richmond, VA 23230-3531
Phone (804) 464-8340

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024172800VAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Unique Holistic Care LLC Psychiatric/Mental Health CurrentSince Aug 24, 2016 Accepting new patients
Beacon Behavioral Health and Consulting, LLC Psychiatric/Mental Health Current Accepting new patients

Locations

4901 Fitzhugh Ave
Ste 200
Richmond, VA 23230
Phone (804) 213-0140

4907 Fitzhugh Ave
Ste 202
Richmond, VA 23230
Phone (804) 396-4106

4914 Fitzhugh Ave
Ste 101
Richmond, VA 23230
Phone (804) 213-2662

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": "1438646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1255717088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4901 FITZHUGH AVE STE 200",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232303531",
            "telephone_number": "804-464-8340",
            "fax_number": "804-884-3726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 FITZHUGH AVE STE 200",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232303531",
            "telephone_number": "804-464-8340",
            "fax_number": "804-884-3726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLARD",
        "first_name": "TONJANIKA",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-04",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024172800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.