Individual provider Active NPI

Nino Chkhaidze, LCP

  • Clinical Psychologist
  • Charlottesville, VA
National Provider Identifier
1891282828
Registry record updated Apr 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810005923 Issued in VA
Practice address
1410 Incarnation Dr # 205
Charlottesville, VA 22901-5708
Phone
(434) 293-4262
NPI assigned
Apr 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 0810005923 VA Primary

Addresses

Primary practice location

1410 Incarnation Dr # 205
Charlottesville, VA 22901-5708

Mailing address

116 Loma LN
Charlottesville, VA 22902-6430
Phone (540) 209-0490

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230531002194 NV Practitioner - Clinical Psychologist 1951713072 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health Psychology Associates LLCGroup PAC ID 6204180284, 15 clinicians

Practice addresses (Care Compare)

245 Mount Rose St
Reno, NV 89509-3355
Phone (775) 448-6828

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
0810005923VAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
G D Shoenberger, Inc. Clinical CurrentSince Feb 23, 2023 Accepting new patients
Health Psychology Associates LLC CurrentSince Feb 23, 2023 Accepting new patients

Locations

245 Mount Rose St
Reno, NV 89509
Phone (775) 448-6828

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1523836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523836800000",
    "number": "1891282828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 LOMA LN",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229026430",
            "telephone_number": "540-209-0490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 INCARNATION DR # 205",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229015708",
            "telephone_number": "434-293-4262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHKHAIDZE",
        "first_name": "NINO",
        "name_prefix": "Dr.",
        "credential": "LCP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-16",
        "last_updated": "2018-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810005923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.