Individual provider Active NPI

Lois Ntiamoah, NURSE PRACTITIONER

  • Psychiatric/Mental Health Nurse Practitioner
  • Reston, VA
National Provider Identifier
1760227300
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0024190470 Issued in VA
Practice address
1850 Town Center Pkwy
Reston, VA 20190-3298
Phone
(202) 766-2390
NPI assigned
Jun 26, 2024
Last updated
Jul 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0024190470 VA Primary

Addresses

Primary practice location

1850 Town Center Pkwy
Reston, VA 20190-3298

Mailing address

2807 N Parham Rd Ste 3204524
Henrico, VA 23294-4410
Phone (202) 766-2390

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240915000038 VA Practitioner - Nurse Practitioner 6709327992 Reassigns benefits to 3 organizations
I20241028004083 DC Practitioner - Nurse Practitioner 6709327992 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rahel G. Yirga MD PCGroup PAC ID 0648335372, 25 clinicians
Revive Behavioral HealthGroup PAC ID 8729516125, 5 clinicians

Practice addresses (Care Compare)

Falls Church, VA 22042
Phone (703) 425-9765

Winchester, VA 22603
Phone (800) 969-1104

Petersburg, VA 23803
Phone (804) 653-7009

24107 Sequoia Rd
North Dinwiddie, VA 23803-8715

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rahel G. Yirga MD PC CurrentSince Aug 1, 2024 Accepting new patients
Revive Behavioral Health CurrentSince Sep 25, 2025 Accepting new patients

Locations

6035 Burke Centre Pkwy
Ste 390
Burke, VA 22015
Phone (703) 978-0756

416 3rd St
Ste D
Petersburg, VA 23803
Phone (804) 653-7009

20 Pidgeon Hill Dr
Ste 208
Sterling, VA 20165
Phone (703) 539-6029

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1719360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1760227300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2807 N PARHAM RD STE 3204524",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232944410",
            "telephone_number": "202-766-2390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 TOWN CENTER PKWY",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201903298",
            "telephone_number": "202-766-2390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NTIAMOAH",
        "first_name": "LOIS",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-26",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024190470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

Verify at the official NPI Registry.