Olivier Bertrand Djoumessi, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

146076 Issued in TX

Practice address

522 W Riverside Ave Ste 5391
Spokane, WA 99201-0580

Phone

(817) 230-3994

NPI assigned

May 19, 2020

Last updated

Mar 12, 2024By the provider in NPPES

Sex

Male

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

Enrolled in TX, WA, FL, CA, DC, OR, CT, NH, IA, CO, MA, ID, AZ, MT, NM15 enrollments

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 15

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mindful Therapy Group PCGroup PAC ID 4981872561, 654 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Mindful Therapy Group PC

  dba Mindful Therapy Group

  • Clinical Social Worker
  • Mountlake Terrace, WA
  • NPI 1316238678

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  AZ, CO, CT, DC, IA, ID, MA, MT, NH, NM, OR, Psychiatric/Mental Health, TX, WA

  Medicare reassignment NPD
• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Sud Specialty Group - Ca

  dba Rula Health

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Santa Clara, CA
  • NPI 1972138238
  Medicare reassignment
• Symbios Plus LLC

  • Behavioral Neurology & Neuropsychiatry Physician
  • Dallas, TX
  • NPI 1457240707
  Medicare reassignment
• Advanced Medical & Psychiatry Group PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Spokane, WA
  • NPI 1003689282
  Authorized official Same address or phone
• Advanced Medical & Psychiatry Group PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • St Petersburg, FL
  • NPI 1184497372
  Authorized official Same address or phone
• Advanced Medical & Psychiatry Group PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Oro Valley, AZ
  • NPI 1356114540
  NPD (past) Authorized official
• Advanced Medical & Psychiatry Group PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Austin, TX
  • NPI 1578336756
  Authorized official Same address or phone
• Advanced Medical & Psychiatry Group PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Boulder, CO
  • NPI 1619740800
  NPD (past) Authorized official
• Advanced Psychiatry & Addiction Treatment Center LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Sacramento, CA
  • NPI 1760255947
  Authorized official Same address or phone
• Advanced Psychiatry & Addiction Treatment Center LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Albany, NY
  • NPI 1962275149
  Authorized official Same address or phone

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

{
    "created_epoch": "1589846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1568085074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4402 LONGBOURN DR",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760632252",
            "telephone_number": "817-230-3994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 W RIVERSIDE AVE STE 5391",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992010580",
            "telephone_number": "817-230-3994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DJOUMESSI",
        "first_name": "OLIVIER",
        "middle_name": "BERTRAND",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-19",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61420571",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "146076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Dixon, M.D.
• Sierra Nicole Dixon, OTR/L
• Steven L. Dixon, M.D.
• Kye Sinclair Dixson, PA-C
• Michael Dean Dixson, M.D.
• DK Reliable Transportation LLC (Care Route Medical Transportation)
• Dluxe Mobility Solutions Inc
• Danielle Linh DO
• Johnson DO
• Suzanna Brooke Doan, LMP

• Psychiatric/Mental Health Nurse Practitioner in Spokane, WA
• Providers in Spokane, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.