Rose Ifeyinwa Idemili

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

0024188680 Issued in VA

Practice address

411 Branchway Rd Ste 109
North Chesterfield, VA 23236-3034

Phone

(804) 901-0053

NPI assigned

Oct 24, 2023

Last updated

Mar 19, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in VA, DC, WA, MN, ND5 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 5

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Riversbend Hospitalists P.C.Group PAC ID 3375620933, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

28.25 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

94.18

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Riversbend Hospitalists P.C.

  dba RBH Medical Center

  • Hospitalist Physician
  • Colonial Heights, VA
  • NPI 1861680662
  Medicare reassignment Care Compare group NPD
• Maxgio Healthcare LLC

  • Nurse Practitioner
  • North Chesterfield, VA
  • NPI 1891550786

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  DC, MN, ND, Psychiatric/Mental Health, WA

  Medicare reassignment NPD
• Rhodium Care Group Inc

  • Psychologist
  • Lakewood, NJ
  • NPI 1235853698

  DC, VA

  Medicare reassignment NPD
• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442

  Psychiatric/Mental Health, VA

  Medicare reassignment NPD
• Bend Health Psychiatric Services Midwest PC

  • Adolescent and Children Mental Health Clinic/Center
  • Madison, WI
  • NPI 1063177251
  NPD (past)
• Bend Health Psychiatric Services New England PA

  • Adolescent and Children Mental Health Clinic/Center
  • Madison, WI
  • NPI 1932864022
  NPD (past)

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

{
    "created_epoch": "1698105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1912779885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15721 WHIRLAND DR",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231125255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 BRANCHWAY RD STE 109",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232363034",
            "telephone_number": "804-901-0053"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9036 35th Avenue",
            "address_2": "Suite B",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "98126",
            "country_code": "US",
            "telephone_number": "415-671-2165",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3611 Boulevard",
            "address_purpose": "LOCATION",
            "city": "Colonial Heights",
            "state": "VA",
            "postal_code": "238341344",
            "country_code": "US",
            "telephone_number": "701-729-2970",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IDEMILI",
        "first_name": "ROSE",
        "middle_name": "IFEYINWA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-24",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ND",
            "license": "R48562",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "61498395",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024188680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Vladimirovna Ickes, LPC
• Elizabeth Iddings
• Ideal Dental Care , Inc
• Ideal Family Dentistry LLC
• Innocent Onyebuchi Idemili
• Rachel Igou
• Impact Adult Services, LLC
• Impact Wellness Center LLC
• In Good Hands Transportation, LLC
• In the Beginning Incubator and Fund Company

• Psychiatric/Mental Health Nurse Practitioner in North Chesterfield, VA
• Providers in North Chesterfield, 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 Mar 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.