Individual provider Active NPI

Patricia Mourilhe McEntire, MD

  • Psychiatry Physician
  • Fort Lee, VA
National Provider Identifier
1568425486
Registry record updated Oct 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
D0066761 Issued in MD
Practice address
700 24TH St
Kenner Army Clinic
Fort Lee, VA 23801-1716
Phone
(804) 734-9295
NPI assigned
Apr 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Forensic Psychiatry Physician 2084F0202X 218670-1 NY
Psychiatry Physician 2084P0800X D0066761 MD Primary

Addresses

Primary practice location

700 24TH St
Kenner Army Clinic
Fort Lee, VA 23801-1716

Mailing address

1613 Dunterry PL
MC Lean, VA 22101-4318
Phone (212) 566-7048

Other identifiers 1

IdentifierTypeStateIssuer
5905428MedicaidNC

Other names 1

  • Dr. Patricia Mourilhe Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20161010001280 VA Practitioner - Psychiatry 0840292876 Reassigns benefits to 1 organization
I20161021000797 DC Practitioner - Psychiatry 0840292876 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
218670-1NYMDForensic Psychiatry Physician
D0066761MDMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services Psychiatry CurrentSince Oct 17, 2016 Accepting new patients
Inova Health Care Services CurrentSince Oct 17, 2016 Accepting new patients

Locations

1701 N George Mason Dr
Arlington, VA 22205
Phone (703) 558-5000

8505 Arlington Blvd
Ste 200
Fairfax, VA 22031
Phone (703) 698-8525

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224115200000",
    "number": "1568425486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1613 DUNTERRY PL",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221014318",
            "telephone_number": "212-566-7048",
            "fax_number": "866-648-7658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 24TH ST",
            "address_2": "KENNER ARMY CLINIC",
            "city": "FORT LEE",
            "state": "VA",
            "postal_code": "238011716",
            "telephone_number": "804-734-9295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCENTIRE",
        "first_name": "PATRICIA",
        "middle_name": "MOURILHE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-11",
        "last_updated": "2008-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "NY",
            "license": "218670-1",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "D0066761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5905428",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICIA",
            "last_name": "MOURILHE",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Lee, VA

Sources for this page

Verify at the official NPI Registry.