NPIMap

Organization Active NPI

Totally Psyched, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Winter Garden, FL
National Provider Identifier
1396479697
Registry record updated May 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
TOTALLY PSYCHED, LLC
Practice address
1223 Daniels Rd
Winter Garden, FL 34787-3835
Phone
(689) 240-7945
Fax
(833) 973-2664
NPI assigned
Jul 12, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2025

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

Authorized official

Name
Mr. Kristopher Stewart Oldham, PMHNP-BCNPI 1619357787
Title
Owner
Phone
(817) 689-3369

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

1223 Daniels Rd
Winter Garden, FL 34787-3835

Mailing address

15161 Newtonia St
Winter Garden, FL 34787-5647
Phone (817) 689-3369

Other practice location 1

13350 W Colonial Dr Ste 340
Winter Garden, FL 34787-3977
Phone (689) 240-7945

Other practice location 2

15161 Newtonia St
Winter Garden, FL 34787-5647
Phone (817) 689-3369

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220901000603 FL Part B Supplier - Clinic/Group Practice 7113301680 Receives reassigned benefits from 6 practitioners
Practice locations: Winter Garden, FL

National Provider Directory

National Provider Directory

Locations

1223 Daniels Rd
Winter Garden, FL 34787
Phone (689) 240-7945

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1657584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746144000000",
    "number": "1396479697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15161 NEWTONIA ST",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347875647",
            "telephone_number": "817-689-3369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1223 DANIELS RD",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347873835",
            "telephone_number": "689-240-7945",
            "fax_number": "833-973-2664"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13350 W Colonial Dr Ste 340",
            "address_purpose": "LOCATION",
            "city": "Winter Garden",
            "state": "FL",
            "postal_code": "347873977",
            "country_code": "US",
            "telephone_number": "689-240-7945",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15161 Newtonia St",
            "address_purpose": "LOCATION",
            "city": "Winter Garden",
            "state": "FL",
            "postal_code": "347875647",
            "country_code": "US",
            "telephone_number": "817-689-3369",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TOTALLY PSYCHED, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-12",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A",
        "authorized_official_last_name": "OLDHAM",
        "authorized_official_first_name": "KRISTOPHER",
        "authorized_official_middle_name": "STEWART",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-689-3369",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Garden, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.