Individual provider Active NPI

Efetze Metangpa Akana

  • Psychiatric/Mental Health Nurse Practitioner
  • Fredericksburg, VA
National Provider Identifier
1619704996
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0024191249 Issued in VA
Practice address
6308 Five Mile Centre Park Ste 217
Fredericksburg, VA 22407-5508
Phone
(571) 359-8782
NPI assigned
Sep 19, 2024
Last updated
Sep 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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 0024191249 VA Primary

Addresses

Primary practice location

6308 Five Mile Centre Park Ste 217
Fredericksburg, VA 22407-5508

Mailing address

6308 Five Mile Centre Park Ste 217
Fredericksburg, VA 22407-5508
Phone (571) 359-8782

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
I20250129002678 VA Practitioner - Nurse Practitioner 3678002003 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Holistic Wellness Group LLCGroup PAC ID 0547627366, 6 clinicians

Practice addresses (Care Compare)

6308 Five Mile Centre Park
Suite 217
Fredericksburg, VA 22407-5508
Phone (571) 409-8390

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Holistic Wellness Group LLC Psychiatric/Mental Health CurrentSince Oct 1, 2024 Accepting new patients
A&M Quality Services CurrentSince Dec 14, 2025 Accepting new patients

Locations

6308 Five Mile Centre Park
Ste 217
Fredericksburg, VA 22407
Phone (571) 409-8390

6308 Five Mile Centre Park
Ste 219
Fredericksburg, VA 22407
Phone (540) 642-0883

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, 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": "1726704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1619704996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6308 FIVE MILE CENTRE PARK STE 217",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224075508",
            "telephone_number": "571-359-8782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6308 FIVE MILE CENTRE PARK STE 217",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224075508",
            "telephone_number": "571-359-8782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AKANA",
        "first_name": "EFETZE",
        "middle_name": "METANGPA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-19",
        "last_updated": "2024-09-19",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024191249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

Verify at the official NPI Registry.