Individual provider Active NPI

Elisabeth Nkem, LNMHP

  • Psychiatric/Mental Health Nurse Practitioner
  • Fredericksburg, VA
National Provider Identifier
1295448983
Registry record updated Apr 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0024186114 Issued in VA
Practice address
6308 Five Mile Centre Park Ste 219
Fredericksburg, VA 22407-5508
Phone
(571) 409-8390
NPI assigned
Dec 28, 2022
Last updated
Apr 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 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 0024186114 VA Primary

Addresses

Primary practice location

6308 Five Mile Centre Park Ste 219
Fredericksburg, VA 22407-5508

Mailing address

12806 Glendale CT
Fredericksburg, VA 22407-2060
Phone (571) 409-8390

Other identifiers 1

IdentifierTypeStateIssuer
05MedicaidVA

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
I20230208001081 VA Practitioner - Nurse Practitioner 7012389620 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Holistic Wellness Group LLCGroup PAC ID 0547627366, 6 clinicians

Practice addresses (Care Compare)

6308 Five Mile Centre Park
Suite 217
Fredericksburg, VA 22407-5508
Phone (571) 409-8390

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

OrganizationSpecialtyStatusNew patients
Holistic Wellness Group LLC Psychiatric/Mental Health CurrentSince Apr 19, 2023 Accepting new patients

Locations

6308 Five Mile Centre Park
Ste 217
Fredericksburg, VA 22407
Phone (571) 359-8782

6308 Five Mile Centre Park
Ste 219
Fredericksburg, VA 22407
Phone (540) 642-0883

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1672185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1295448983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12806 GLENDALE CT",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224072060",
            "telephone_number": "571-409-8390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6308 FIVE MILE CENTRE PARK STE 219",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224075508",
            "telephone_number": "571-409-8390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NKEM",
        "first_name": "ELISABETH",
        "name_prefix": "Mrs.",
        "credential": "LNMHP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-28",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024186114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

Verify at the official NPI Registry.