Ase' Revival Telepsychiatry LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

ASE' REVIVAL TELEPSYCHIATRY LLC

Practice address

4410 East Claiborne Square, Suite 334,
Hampton, VA 23666

Phone

(804) 933-1463

Fax

(757) 520-4668

NPI assigned

Oct 9, 2025

Organization subpart

No

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

Authorized official

Name

Miss Tiphanie Michele Jones, PMHNP-BCNPI 1912752718

Title

Ceo/ Pmhnp-BC

Phone

(804) 933-1463

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC, VA2 enrollments

Enrollment records 2

Locations

Practitioners 1

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

• Tiphanie Jones, RN

  • Psychiatric/Mental Health Nurse Practitioner
  • Hampton, VA
  • NPI 1912752718

  NC

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1759968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759968000000",
    "number": "1588539449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 COLISEUM XING # 5228",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236665971",
            "telephone_number": "804-933-1463",
            "fax_number": "757-520-4668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4410 EAST CLAIBORNE SQUARE, SUITE 334,",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "23666",
            "telephone_number": "804-933-1463",
            "fax_number": "757-520-4668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASE' REVIVAL TELEPSYCHIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-09",
        "last_updated": "2025-10-09",
        "certification_date": "2025-09-20",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "TIPHANIE",
        "authorized_official_middle_name": "MICHELE",
        "authorized_official_title_or_position": "CEO/ PMHNP-BC",
        "authorized_official_telephone_number": "804-933-1463",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adeniyi Ashimi

• Psychiatric/Mental Health Nurse Practitioner in Hampton, VA
• Providers in Hampton, VA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2025; 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.