Elise R Douglass, PMHNP-BC, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

0024189032 Issued in VA

Practice address

400 Medical Dr
Hampton, VA 23666-1767

Phone

(757) 788-0400

Fax

(757) 788-0957

NPI assigned

Feb 14, 2024

Last updated

Mar 10, 2025By 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

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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hampton Newport News Community Services BoardGroup PAC ID 0446247480, 26 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Hampton Newport News Community Services Board

  • Community/Behavioral Health Agency
  • Hampton, VA
  • NPI 1659424448
  Medicare reassignment Care Compare group NPD
• Brightview LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Lynchburg, VA
  • NPI 1649786260
  Medicare reassignment NPD
• Brightview LLC

  • Addiction Medicine (Internal Medicine) Physician
  • Asheboro, NC
  • NPI 1962163782
  NPD

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

{
    "created_epoch": "1707868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1376308957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MEDICAL DR",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236661765",
            "telephone_number": "757-788-0300",
            "fax_number": "757-788-0969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MEDICAL DR",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236661767",
            "telephone_number": "757-788-0400",
            "fax_number": "757-788-0957"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1021 Eden Way N Ste 118",
            "address_purpose": "LOCATION",
            "city": "Chesapeake",
            "state": "VA",
            "postal_code": "233202776",
            "country_code": "US",
            "telephone_number": "757-816-6964",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUGLASS",
        "first_name": "ELISE",
        "middle_name": "R",
        "credential": "PMHNP-BC, APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-14",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024189032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Donaldson
• Richard John Donzell Jr., D.D.S.
• Abigail Grace Dors
• Timothy Richard Doty
• Kedeisha Ann-Marie Dougherty
• Janelle Downes
• Quindell Clifford Doyle, SLP
• Aileen Dozier
• Tamara Dozier
• DQS Communication, LLC

• Psychiatric/Mental Health Nurse Practitioner in Hampton, VA
• Providers in Hampton, 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 Mar 10, 2025; 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.