Individual provider Active NPI

Arnella M Edwards

  • Psychiatric/Mental Health Nurse Practitioner
  • Virginia Beach, VA
National Provider Identifier
1457802795
Registry record updated Oct 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0017143373 Issued in VA
Practice address
240 Business Park Dr
Virginia Beach, VA 23462-6521
Phone
(757) 497-3670
Fax
(757) 499-1947
NPI assigned
Oct 21, 2016
Last updated
Oct 21, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2016

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 0017143373 VA Primary

Addresses

Primary practice location

240 Business Park Dr
Virginia Beach, VA 23462-6521

Mailing address

3528 Old Grandad LN
Chesapeake, VA 23323-1170
Phone (757) 472-9034

Other names 1

  • Ms. Arnella M Nelson Other name

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
I20170424001416 VA Practitioner - Nurse Practitioner 2860778099 Reassigns benefits to 2 organizations
Practice locations: Portsmouth, VA

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3412 Columbia St
Portsmouth, VA 23707-3201
Phone (757) 606-1213

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0017143373VAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Psychotherapy Services CurrentSince Jul 24, 2022 Accepting new patients
Sobriety & Suboxone Holistic Services Psychiatric/Mental Health CurrentSince May 19, 2021 Accepting new patients
Tidewater Psychotherapy Services CurrentSince Jan 31, 2017 Accepting new patients

Locations

3412 Columbia St
Portsmouth, VA 23707
Phone (757) 472-9034

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

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1477008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477008000000",
    "number": "1457802795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3528 OLD GRANDAD LN",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233231170",
            "telephone_number": "757-472-9034",
            "fax_number": "757-953-0901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 BUSINESS PARK DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234626521",
            "telephone_number": "757-497-3670",
            "fax_number": "757-499-1947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "ARNELLA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-21",
        "last_updated": "2016-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0017143373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ARNELLA",
            "last_name": "NELSON",
            "middle_name": "M",
            "prefix": "MS.",
            "credential": "PMHNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.