Megan Jean Zamora

Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Halifax, VA

NPI 1992354476 · NPPES record last updated Nov 21, 2023

Key facts

NPI
1992354476
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
License
0024178166 (VA)
Practice address
5037 Halifax Rd Ste U4
Halifax, VA 24558-3243
Phone
(434) 303-2300
NPI assigned
Sep 8, 2019
Sex
Female
Sole proprietor
Yes

Organizations & group practices 3

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.

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

490 Buena Vista Dr
Halifax, VA 24558-2152
Phone (434) 303-2300

Medicare participation

Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20191203000140 VA Practitioner - Nurse Practitioner 0749613982 Reassigns benefits to 3 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
0024178166VAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southside Behavioral Health Current
since Oct 7, 2019
Accepting new patients
Mental Swellness Psychiatric/Mental Health Current
since Jan 4, 2022
Accepting new patients
In Harmony Wellness Ihw LLC Current
since Sep 20, 2022
Accepting new patients

Locations

523 Madison St
Boydton, VA 23917
Phone (434) 738-0154

143 Industrial Pkwy
Clarksville, VA 23927
Phone (434) 572-6916

5037 Halifax Rd
Ste U4
Halifax, VA 24558
Phone (434) 303-2300

4410 Claiborne Sq E
Ste 334
Hampton, VA 23666
Phone (757) 606-1377

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0024178166 VA Yes

Addresses

Primary practice location

5037 Halifax Rd Ste U4
Halifax, VA 24558-3243

Mailing address

PO Box 253
Halifax, VA 24558-0253
Phone (434) 303-2300

Other practice location 1

5037 Halifax Rd Ste U4
Halifax, VA 24558-3243
Phone (434) 303-2300

Other names

  • Megan Jean Staples Former name

Other providers in Halifax, VA

All providers in Halifax, VA · Psychiatric/Mental Health Nurse Practitioner in Virginia

Sources for this page

Verify at the official NPI Registry.