Individual provider Active NPI

Glory Mbong-Ngwa

  • Psychiatric/Mental Health Nurse Practitioner
  • Hampton, VA
National Provider Identifier
1346873171
Registry record updated Feb 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0024178723 Issued in VA
Practice address
2244 Executive Dr
Hampton, VA 23666-2430
Phone
(757) 240-2410
NPI assigned
Feb 20, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2020

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 0024178723 VA Primary

Addresses

Primary practice location

2244 Executive Dr
Hampton, VA 23666-2430

Mailing address

3148 Poplar Hill Rd # 2
Chesapeake, VA 23321-5550
Phone (757) 228-2584

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
I20200402001032 VA Practitioner - Nurse Practitioner 0749619336 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Physician Services IncGroup PAC ID 5092608448, 793 clinicians

Practice addresses (Care Compare)

2244 Executive Dr
Hampton, VA 23666-2430
Phone (757) 827-1001

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.91 of 100Reported as apm
Quality
92.86
Promoting interoperability
94.93
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0024178723VAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Physician Services Inc CurrentSince Mar 25, 2020 Accepting new patients
Riverside Physician Services Inc Current Accepting new patients
Riverside Physician Services, Inc. CurrentSince Mar 25, 2020 Accepting new patients

Locations

2244 Executive Dr
Hampton, VA 23666
Phone (757) 827-1001

858 J Clyde Morris Blvd
Newport News, VA 23601
Phone (757) 594-4343

856 J Clyde Morris Blvd
Ste A
Newport News, VA 23601
Phone (757) 316-5900

Interoperability endpoints

  • Direct secure messaging: gmbongngwa141827@direct.rivhs.com

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1582156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582156800000",
    "number": "1346873171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3148 POPLAR HILL RD # 2",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233215550",
            "telephone_number": "757-228-2584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2244 EXECUTIVE DR",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236662430",
            "telephone_number": "757-240-2410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MBONG-NGWA",
        "first_name": "GLORY",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-20",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024178723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton, VA

Sources for this page

Verify at the official NPI Registry.