Individual provider Active NPI

Victoria Marie Hall, APRN, DNP, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Cheyenne, WY
National Provider Identifier
1972070134
Registry record updated Oct 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
25677.1815 Issued in WY
Practice address
2360 E Pershing Blvd
Cheyenne, WY 82001-5356
Phone
(307) 778-7550
NPI assigned
Oct 25, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2018

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 25677.1815 WY Primary

Addresses

Primary practice location

2360 E Pershing Blvd
Cheyenne, WY 82001-5356

Mailing address

14304 E Four Mile Rd
Cheyenne, WY 82009-8724
Phone (307) 214-5273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
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
I20231228003348 WY Practitioner - Nurse Practitioner 0143670430 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
A Beautiful Mind LLCGroup PAC ID 5496182321, 2 clinicians

Practice addresses (Care Compare)

145 S Durbin St
Suite 301
Casper, WY 82601-2567
Phone (307) 337-1173

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
25677.1815WYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
A Beautiful Mind LLC Psychiatric/Mental Health CurrentSince Nov 28, 2023 Accepting new patients

Locations

145 S Durbin St
Ste 207
Casper, WY 82601
Phone (307) 337-1173

145 S Durbin St
Ste 301
Casper, WY 82601
Phone (307) 337-1173

Organizations & group practices 1

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": "1540425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540425600000",
    "number": "1972070134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14304 E FOUR MILE RD",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820098724",
            "telephone_number": "307-214-5273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2360 E PERSHING BLVD",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820015356",
            "telephone_number": "307-778-7550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "VICTORIA",
        "middle_name": "MARIE",
        "credential": "APRN, DNP, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-25",
        "last_updated": "2018-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WY",
            "license": "25677.1815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheyenne, WY

Sources for this page

Verify at the official NPI Registry.