NPIMap

Organization Active NPI

Transforming Minds Interventional Psychiatry

  • Psychiatric/Mental Health Nurse Practitioner
  • Chesapeake, VA
National Provider Identifier
1427773308
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
TRANSFORMING MINDS INTERVENTIONAL PSYCHIATRY
Practice address
200 Carmichael Way Ste 604
Chesapeake, VA 23322-2489
Phone
(757) 908-2124
Fax
(757) 908-2320
NPI assigned
Oct 4, 2022
Last updated
May 15, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2024

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

Authorized official

Name
Justin Ray, PMHNP-BCNPI 1093013641
Title
Owner
Phone
(757) 908-2124

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

200 Carmichael Way Ste 604
Chesapeake, VA 23322-2489

Mailing address

200 Carmichael Way Ste 604
Chesapeake, VA 23322-2489
Phone (757) 908-2124

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221214001533 VA Part B Supplier - Clinic/Group Practice 2961871967 Receives reassigned benefits from 4 practitioners
Practice locations: Chesapeake, VA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1664841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715731200000",
    "number": "1427773308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CARMICHAEL WAY STE 604",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233222489",
            "telephone_number": "757-908-2124",
            "fax_number": "757-908-2320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 CARMICHAEL WAY STE 604",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233222489",
            "telephone_number": "757-908-2124",
            "fax_number": "757-908-2320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRANSFORMING MINDS INTERVENTIONAL PSYCHIATRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-04",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A",
        "authorized_official_last_name": "RAY",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-908-2124",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "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 Chesapeake, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2024; 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.