NPIMap

Organization Active NPI

Churchland Psychiatric Associates PC

  • Psychiatry Physician
  • Chesapeake, VA
National Provider Identifier
1740359223
Registry record updated Nov 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
CHURCHLAND PSYCHIATRIC ASSOCIATES PC
Practice address
4041 Taylor Rd Ste G
Chesapeake, VA 23321-5525
Phone
(757) 483-6404
Fax
(757) 483-0737
NPI assigned
Nov 7, 2006
Last updated
Nov 7, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2021

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

Authorized official

Name
Michelle Colley
Title
Business Administrator
Phone
(757) 483-6404

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

4041 Taylor Rd Ste G
Chesapeake, VA 23321-5525

Mailing address

4041 Taylor Rd Ste G
Chesapeake, VA 23321-5525
Phone (757) 483-6404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040519001370 VA Part B Supplier - Clinic/Group Practice 5799776654 Receives reassigned benefits from 18 practitioners
Practice locations: Chesapeake, VA

National Provider Directory

National Provider Directory

Locations

3300 Academy Ave
Portsmouth, VA 23703
Phone (757) 483-6404

Interoperability endpoints

  • Direct secure messaging: federicovizcaino@cpai.allscriptsdirect.net
  • Direct secure messaging: garystarkey@cpai.allscriptsdirect.net
  • Direct secure messaging: marlaclancy@cpai.allscriptsdirect.net
  • Direct secure messaging: richardeanbenjamin@cpai.allscriptsdirect.net
  • Direct secure messaging: tonyaalexander@cpai.allscriptsdirect.net
  • Direct secure messaging: velmabacak@cpai.allscriptsdirect.net

Practitioners & affiliated clinicians

Practitioners 31

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.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636243200000",
    "number": "1740359223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4041 TAYLOR RD STE G",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233215525",
            "telephone_number": "757-483-6404",
            "fax_number": "757-483-0737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4041 TAYLOR RD STE G",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233215525",
            "telephone_number": "757-483-6404",
            "fax_number": "757-483-0737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHURCHLAND PSYCHIATRIC ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2021-11-07",
        "certification_date": "2021-11-07",
        "status": "A",
        "authorized_official_last_name": "COLLEY",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "BUSINESS ADMINISTRATOR",
        "authorized_official_telephone_number": "757-483-6404"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2021; 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.

Verify at the official NPI Registry.