Viktoriya V. Ivantsova, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

2024044289 Issued in MO

Practice address

930 Kehrs Mill Rd
Ballwin, MO 63011-2462

Phone

(314) 606-0893

NPI assigned

Nov 5, 2024

Last updated

Sep 11, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Great Mines Health CenterGroup PAC ID 3072598143, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Great Mines Health Center

  • Federally Qualified Health Center (FQHC)
  • Potosi, MO
  • NPI 1376536953
  Medicare reassignment Care Compare group NPD
• Great Mines Health Center

  dba Farmington R-VII - Dayse Baker Learning Center

  • Federally Qualified Health Center (FQHC)
  • Farmington, MO
  • NPI 1073188462
  NPD

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

{
    "created_epoch": "1730764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789084800000",
    "number": "1689497877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 KEHRS MILL RD",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630112462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 KEHRS MILL RD",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630112462",
            "telephone_number": "314-606-0893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVANTSOVA",
        "first_name": "VIKTORIYA",
        "middle_name": "V.",
        "name_prefix": "Ms.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-05",
        "last_updated": "2026-09-11",
        "certification_date": "2026-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2024044289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaron L Inch, MPT
• Shanna M Ingram, FNP-C
• Elizabeth Irwin, LPC
• Annette Israel
• Rasha Issou
• Margaret Kathleen Jackson, M.S., CCCSLP
• Jaks Counseling Services
• James H Stanford DDS PC
• Adam David James
• Jensen Health Enterprises (Nutrition Clinic)

• Psychiatric/Mental Health Nurse Practitioner in Ballwin, MO
• Providers in Ballwin, MO by specialty
• Psychiatric/Mental Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2026; 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.