Holly Disibbio, PMHNP-BC
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Bluefield, VA
NPI 1700423019 · NPPES record last updated Jul 31, 2024
Key facts
- NPI
- 1700423019
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 104840 (WV)
- Practice address
- 105 Westwood CMN
Bluefield, VA 24605-2031 - Phone
- (276) 235-6232
- Fax
- (276) 250-5117
- NPI assigned
- Dec 5, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.34 of 100
- Quality
- 79.86
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WV, VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200219001829 | WV | Practitioner - Nurse Practitioner | 5799112454 | Reassigns benefits to 1 organization |
| I20240403001975 | VA | Practitioner - Nurse Practitioner | 5799112454 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 104840 | WV | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East River Psychiatry | Current |
Accepting new patients |
Locations
105 Westwood Cmn
Bluefield, VA 24605
Phone (276) 235-6232
Interoperability endpoints
- holly.disibbio.1@30447.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 104840 | WV | Yes |
Addresses
Primary practice location
105 Westwood CMN
Bluefield, VA 24605-2031
Mailing address
105 Westwood CMN
Bluefield, VA 24605-2031
Phone (276) 235-6232
Other names
- Miss Holly Disibbio
Other providers in Bluefield, VA
- Dustin Dean
- Stephen Alan Degray
- Derm One, PLLC
- Dermatology Clinics of Southwest Virginias PLLC
- Hilary Beth Deskins
- Bobby Quentin Dunford
- Donna Elaine Dunford
- Alfred James Dyer
- East River Psychiatry
- Constance L. Erickson
All providers in Bluefield, VA · Psychiatric/Mental Health Nurse Practitioner in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 31, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.