Amber Dise

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

0024184766 Issued in VA

Practice address

12572 Plymouth CT
Woodbridge, VA 22192-2321

Phone

(703) 492-4740

NPI assigned

Jul 6, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Practice roles

Interoperability endpoints

• Direct secure messaging: amber.dise.1@29379.direct.athenahealth.com

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.

• Amber Dise Psychiatry and Wellness PLLC

  • Community/Behavioral Health Agency
  • Lorton, VA
  • NPI 1508608654
  NPD Authorized official
• Beeu Counseling PLLC

  • Mental Health Counselor
  • Lorton, VA
  • NPI 1710671318
  NPD (past)

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

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1427345867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12572 PLYMOUTH CT",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221922321",
            "telephone_number": "703-498-7684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12572 PLYMOUTH CT",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221922321",
            "telephone_number": "703-492-4740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISE",
        "first_name": "AMBER",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-06",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001179853",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024184766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dilana Dilixiati
• Kerry Anne Dillman, M.A., B.C.B.A.
• Makayla A Dineen
• Amber N Dingus
• Discovery Health LLC
• District Dental Studio PLLC
• District Endocrine LLC
• Tina Louise Dittmer, BCBA
• Diverse Abilities
• Divine Health Support LLC

• Psychiatric/Mental Health Nurse Practitioner in Woodbridge, VA
• Providers in Woodbridge, 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 Oct 16, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.