Active NPI
East River Psychiatry
- Psychiatry Physician
- Bluefield, VA
National Provider Identifier
1689445884
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- Legal business name
- EAST RIVER PSYCHIATRY
- Practice address
- 105 Westwood CMN
Bluefield, VA 24605-2031 - Phone
- (276) 235-6232
- Fax
- (276) 250-5117
- NPI assigned
- Jan 16, 2024
- Last updated
- Feb 12, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Holly Disibbio, NP
- Title
- Employee
- Phone
- (301) 904-3804
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | Primary | ||
| Community/Behavioral Health Agency | 251S00000X |
Addresses
Primary practice location
105 Westwood CMN
Bluefield, VA 24605-2031
Mailing address
105 Westwood CMN
Bluefield, VA 24605-2031
Phone (276) 235-6232
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA, WV
Enrollment records 2
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Psychiatric/Mental Health Nurse Practitioner
- Bluefield, VA
- NPI 1700423019
WV
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1705363200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1707696000000",
"number": "1689445884",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 WESTWOOD CMN",
"city": "BLUEFIELD",
"state": "VA",
"postal_code": "246052031",
"telephone_number": "276-235-6232",
"fax_number": "276-250-5117"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 WESTWOOD CMN",
"city": "BLUEFIELD",
"state": "VA",
"postal_code": "246052031",
"telephone_number": "276-235-6232",
"fax_number": "276-250-5117"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EAST RIVER PSYCHIATRY",
"organizational_subpart": "NO",
"enumeration_date": "2024-01-16",
"last_updated": "2024-02-12",
"certification_date": "2024-02-12",
"status": "A",
"authorized_official_last_name": "DISIBBIO",
"authorized_official_first_name": "HOLLY",
"authorized_official_title_or_position": "EMPLOYEE",
"authorized_official_telephone_number": "301-904-3804",
"authorized_official_credential": "NP"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": null,
"license": null,
"primary": true
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bluefield, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.