Psychiatric Services and Medication Management Inc

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP60451837 Issued in WA

Legal business name

PSYCHIATRIC SERVICES AND MEDICATION MANAGEMENT INC

Practice address

12615 E Mission Ave Ste 310
Spokane Valley, WA 99216-1047

Phone

(509) 707-8581

NPI assigned

May 14, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Fred M Itveldt, ARNPNPI 1619393204

Title

Arnp

Phone

(509) 707-8581

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Fred Michael Itveldt, MSN

  • Psychiatric/Mental Health Nurse Practitioner
  • Spokane Valley, WA
  • NPI 1619393204
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1526256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664323200000",
    "number": "1710477807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12615 E MISSION AVE STE 310",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992161047",
            "telephone_number": "509-707-8581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12615 E MISSION AVE STE 310",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992161047",
            "telephone_number": "509-707-8581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHIATRIC SERVICES AND MEDICATION MANAGEMENT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-14",
        "last_updated": "2022-09-28",
        "certification_date": "2020-09-18",
        "status": "A",
        "authorized_official_last_name": "ITVELDT",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ARNP",
        "authorized_official_telephone_number": "509-707-8581",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP60451837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• James J Psomas, DDS
• Psychiatric Solutions LLC
• Sharanjot Punghlia
• Miguel Punsalan, LMT
• Kimberly Rae Puntney, CDP
• Kathryn Purdum

• Psychiatric/Mental Health Nurse Practitioner in Spokane Valley, WA
• Providers in Spokane Valley, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.