Individual provider Active NPI

Joe Darnell Trickey Jr., PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Farmville, VA
National Provider Identifier
1821745670
Registry record updated Mar 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0024183317 Issued in VA
Practice address
60 Bush River Dr
Farmville, VA 23901-3178
Phone
(434) 392-7049
NPI assigned
Mar 2, 2022
Last updated
Mar 2, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2022

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 0024183317 VA Primary

Addresses

Primary practice location

60 Bush River Dr
Farmville, VA 23901-3178

Mailing address

PO Box 248
Farmville, VA 23901-0248
Phone (434) 392-7049

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20220420002722 VA Practitioner - Nurse Practitioner 7719374784 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southside Behavioral HealthGroup PAC ID 4284660507, 14 clinicians

Practice addresses (Care Compare)

424 Hamilton Blvd
South Boston, VA 24592-5200
Phone (434) 572-2936

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0024183317VAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southside Behavioral Health Single Specialty CurrentSince Nov 16, 2022 Accepting new patients
Vaught Christian Counseling PC Single Specialty Past Accepting new patients

Locations

424 Hamilton Blvd
South Boston, VA 24592
Phone (434) 572-2936

823 N Mecklenburg Ave
South Hill, VA 23970
Phone (434) 447-7601

Organizations & group practices 2

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": "1646179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1821745670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 248",
            "city": "FARMVILLE",
            "state": "VA",
            "postal_code": "239010248",
            "telephone_number": "434-392-7049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 BUSH RIVER DR",
            "city": "FARMVILLE",
            "state": "VA",
            "postal_code": "239013178",
            "telephone_number": "434-392-7049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRICKEY",
        "first_name": "JOE",
        "middle_name": "DARNELL",
        "name_suffix": "Jr.",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-02",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024183317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmville, VA

Sources for this page

Verify at the official NPI Registry.