Acacia Health Partners

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

ACACIA HEALTH PARTNERS

Doing business as

Amend Psychiatry

Practice address

320 E Broadway Ste 214
Hopewell, VA 23860-2812

Phone

(804) 687-5601

NPI assigned

Jun 5, 2022

Organization subpart

No

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

Authorized official

Name

Nasr Rabbi Basir Balla, APRN, PMHNP-BCNPI 1962075572

Title

Owner

Phone

(804) 687-5601

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Amend Psychiatry Doing business as

Electronic endpoints 1

Locations

Practitioners 1

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

• Nasr Basir Balla, NURSE PRACTITIONER

  • Psychiatric/Mental Health Nurse Practitioner
  • Hopewell, VA
  • NPI 1962075572
  NPD Authorized official

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

{
    "created_epoch": "1654387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654387200000",
    "number": "1487383626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 E BROADWAY STE 214",
            "city": "HOPEWELL",
            "state": "VA",
            "postal_code": "238602812",
            "telephone_number": "804-687-5601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 E BROADWAY STE 214",
            "city": "HOPEWELL",
            "state": "VA",
            "postal_code": "238602812",
            "telephone_number": "804-687-5601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACACIA HEALTH PARTNERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-05",
        "last_updated": "2022-06-05",
        "certification_date": "2022-06-05",
        "status": "A",
        "authorized_official_last_name": "BASIR BALLA",
        "authorized_official_first_name": "NASR",
        "authorized_official_middle_name": "RABBI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "804-687-5601",
        "authorized_official_credential": "APRN, PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "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
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1962075572",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER LICENSE",
            "identifier": "0024182223",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "psyknp@myacaciahealth.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "320 E Broadway Ste 214",
            "city": "Hopewell",
            "state": "VA",
            "country_code": "US",
            "postal_code": "238602812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Amend Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Hopewell, VA
• Providers in Hopewell, VA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.