Teresa Juntilla Holmes, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

318175 Issued in NC

Practice address

3077 N Main St Ste 201
Hope Mills, NC 28348-1735

Phone

(910) 275-5766

Fax

(866) 990-0668

NPI assigned

Dec 17, 2024

Last updated

Dec 17, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 NC

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

May accept Medicare assignment

Group practices

Divine Wellness Therapeutic Center, PLLCGroup PAC ID 9931546751, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Divine Wellness Therapeutic Center PLLC

  • Community/Behavioral Health Agency
  • Hope Mills, NC
  • NPI 1578291308
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1734393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1699582122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3116 HAMPTON RIDGE RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283113006",
            "telephone_number": "508-566-4524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3077 N MAIN ST STE 201",
            "city": "HOPE MILLS",
            "state": "NC",
            "postal_code": "283481735",
            "telephone_number": "910-275-5766",
            "fax_number": "866-990-0668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "TERESA",
        "middle_name": "JUNTILLA",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-17",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "318175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Highsmith Family Care Home, LLC
• Alyssa Hill, RN
• Nicole Vrentas Hodges, PT
• Shania Hodges
• April Lynn Hollowell, MT
• Bianco Holmon, MSW, LCSW, LCAS-A
• Home Health Care of North Carolina
• Deborah Ann Hood, DNP
• Hope Family Care Home LLC
• Hope Mills Drug (dba The Medicine Shoppe)

• Psychiatric/Mental Health Nurse Practitioner in Hope Mills, NC
• Providers in Hope Mills, NC by specialty
• Psychiatric/Mental Health Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2024; 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.