Individual provider Active NPI

Edward James Evard, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Virginia Beach, VA
National Provider Identifier
1396344693
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0024180372 Issued in VA
Practice address
260 Grayson Rd
Virginia Beach, VA 23462-4345
Phone
(757) 497-3670
NPI assigned
Oct 19, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 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 0024180372 VA Primary

Addresses

Primary practice location

260 Grayson Rd
Virginia Beach, VA 23462-4345

Mailing address

5345 Fairfield Blvd
Virginia Beach, VA 23464-2509
Phone (757) 633-3662

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
I20210125001748 VA Practitioner - Nurse Practitioner 5092129510 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southeast Virginia Psychiatry PLLCGroup PAC ID 2961944988, 13 clinicians

Practice addresses (Care Compare)

5345 Fairfield Blvd
Virginia Beach, VA 23464-2509
Phone (757) 633-3662

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Norfolk Psychiactric Associates PC CurrentSince Dec 15, 2021 Accepting new patients
Tidewater Psychotherapy Services CurrentSince Oct 21, 2020 Accepting new patients
Southeast Virginia Psychiatry PLLC Psychiatric/Mental Health CurrentSince Apr 20, 2024 Accepting new patients
Tidewater Psychotherapy Services CurrentSince Jul 24, 2022 Accepting new patients

Locations

6353 Center Dr
Ste 204
Norfolk, VA 23502
Phone (757) 461-3313

400 N Center Dr
Ste 100
Norfolk, VA 23502
Phone (757) 908-3754

260 Grayson Rd
Virginia Beach, VA 23462
Phone (757) 459-4640

260 Grayson Rd
Ste 100
Virginia Beach, VA 23462
Phone (757) 497-3670

Organizations & group practices 4

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": "1603065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1396344693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5345 FAIRFIELD BLVD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234642509",
            "telephone_number": "757-633-3662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 GRAYSON RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234624345",
            "telephone_number": "757-497-3670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVARD",
        "first_name": "EDWARD",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-19",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024180372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.