Individual provider Active NPI

Samantha Hasenzahl, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Richmond, VA
National Provider Identifier
1962132035
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0024184707 Issued in VA
Practice address
2301 N Parham Rd Ste 5
Richmond, VA 23229-3171
Phone
(804) 270-1124
Fax
(804) 270-2090
NPI assigned
Jun 13, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 0001269939 VA
Psychiatric/Mental Health Registered Nurse 163WP0808X 0024184707 VA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0024184707 VA Primary

Addresses

Primary practice location

2301 N Parham Rd Ste 5
Richmond, VA 23229-3171

Mailing address

1513 Fort Hill Dr
Richmond, VA 23226-3736
Phone (804) 852-1445

Other practice location 1

4212 Park Place Ct
Glen Allen, VA 23060-3314
Phone (804) 332-5950

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
I20220926000021 VA Practitioner - Nurse Practitioner 9234514423 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
Telehealth
Offers telehealth services
Group practices
Dominion Behavioral HealthcareGroup PAC ID 6709803570, 26 clinicians

Practice addresses (Care Compare)

2301 N Parham Rd
Suite 5
Richmond, VA 23229-3171
Phone (804) 270-1124

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0001269939VAMDRegistered Nurse
0024184707VAMDPsychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Dominion Behavioral Healthcare Current Accepting new patients
Dominion Behavioral Healthcare CurrentSince Jun 1, 2024 Accepting new patients

Locations

703 N Courthouse Rd
North Chesterfield, VA 23236
Phone (804) 639-1136

2305 N Parham Rd
Ste 3
Richmond, VA 23229
Phone (804) 270-1124

2301 N Parham Rd
Ste 5
Richmond, VA 23229
Phone (804) 270-1124

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": "1655078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1962132035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1513 FORT HILL DR",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232263736",
            "telephone_number": "804-852-1445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 N PARHAM RD STE 5",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232293171",
            "telephone_number": "804-270-1124",
            "fax_number": "804-270-2090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4212 Park Place Ct",
            "address_purpose": "LOCATION",
            "city": "Glen Allen",
            "state": "VA",
            "postal_code": "230603314",
            "country_code": "US",
            "telephone_number": "804-332-5950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HASENZAHL",
        "first_name": "SAMANTHA",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-13",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001269939",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024184707",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024184707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.