Theresa Boakye, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

0024189059 Issued in VA

Practice address

109 Abby LN
Fredericksburg, VA 22405-2783

Phone

(703) 589-3024

NPI assigned

Jan 15, 2024

Last updated

Jan 15, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Potomac Shores Mental Health and Wellness LLCGroup PAC ID 7719379072, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

• Potomac Shores Mental Health & Wellness LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Woodbridge, VA
  • NPI 1902562507
  Medicare reassignment Care Compare group NPD
• Town and Country Healthcare Services

  • Psychiatric/Mental Health Nurse Practitioner
  • Fredericksburg, VA
  • NPI 1295683266
  Medicare reassignment NPD Authorized official
• Psychogeriatric Services LLC

  • Psychiatry Physician
  • Columbia, MD
  • NPI 1588689483

  VA

  Medicare reassignment NPD
• Vida Sarkodie Inc.

  • Psychiatric/Mental Health Nurse Practitioner
  • Flanders, NJ
  • NPI 1407452006
  NPD (past)

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

{
    "created_epoch": "1705276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705276800000",
    "number": "1326819673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 ABBY LN",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224052783",
            "telephone_number": "703-589-3024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 ABBY LN",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224052783",
            "telephone_number": "703-589-3024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOAKYE",
        "first_name": "THERESA",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-15",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024189059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANCC CERTIFICATION",
            "identifier": "2023167735",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Fredericksburg, VA
• Providers in Fredericksburg, VA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 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; 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.