Chincoteague Main Street LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

CHINCOTEAGUE MAIN STREET LLC

Practice address

4092 Main St
Chincoteague, VA 23336-2405

Phone

(434) 987-5350

NPI assigned

Oct 21, 2021

Organization subpart

No

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

Authorized official

Name

Denise Crosson, PMHNP-BCNPI 1063497469

Title

President

Phone

(434) 987-5350

Specialties & licenses 1

Addresses

Other names 1

• Chincoteague Health Doing business as

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Practitioners 2

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

• Denise Day Crosson, FNP,PH.D.

  • Psychiatric/Mental Health Nurse Practitioner
  • Chincoteague Island, VA
  • NPI 1063497469
  Medicare reassignment NPD Authorized official
• Penelope Ann Critzer, MSW,L.C.S.W

  • Clinical Social Worker
  • Staunton, VA
  • NPI 1295833663
  NPD

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

{
    "created_epoch": "1634774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683504000000",
    "number": "1871256313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4092 MAIN ST",
            "city": "CHINCOTEAGUE",
            "state": "VA",
            "postal_code": "233362405",
            "telephone_number": "434-987-5350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4092 MAIN ST",
            "city": "CHINCOTEAGUE",
            "state": "VA",
            "postal_code": "233362405",
            "telephone_number": "434-987-5350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHINCOTEAGUE MAIN STREET LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-21",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A",
        "authorized_official_last_name": "CROSSON",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "434-987-5350",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chincoteague Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alyssa J Behr, PHARMD
• Christopher Duer Bott, RPH
• Coastal Rehab LLC
• Linda W Daisey, PHARMACY TECHNICIAN
• Allison Denston, NP
• Eastern Shore Rural Health System Incorporated
• Alya Elsayed-Ali, DDS

• Psychiatric/Mental Health Nurse Practitioner in Chincoteague, VA
• Providers in Chincoteague, VA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2023; 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.