Individual provider Active NPI

Megan Jean Zamora

  • Psychiatric/Mental Health Nurse Practitioner
  • Halifax, VA
National Provider Identifier
1992354476
Registry record updated Nov 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0024178166 Issued in VA
Practice address
5037 Halifax Rd Ste U4
Halifax, VA 24558-3243
Phone
(434) 303-2300
NPI assigned
Sep 8, 2019
Last updated
Nov 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2023

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 0024178166 VA Primary

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 1

  • Megan Jean Staples Former name

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
I20191203000140 VA Practitioner - Nurse Practitioner 0749613982 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0024178166VAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1567900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700524800000",
    "number": "1992354476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 253",
            "city": "HALIFAX",
            "state": "VA",
            "postal_code": "245580253",
            "telephone_number": "434-303-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5037 HALIFAX RD STE U4",
            "city": "HALIFAX",
            "state": "VA",
            "postal_code": "245583243",
            "telephone_number": "434-303-2300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5037 Halifax Rd Ste U4",
            "address_purpose": "LOCATION",
            "city": "Halifax",
            "state": "VA",
            "postal_code": "245583243",
            "country_code": "US",
            "telephone_number": "434-303-2300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZAMORA",
        "first_name": "MEGAN",
        "middle_name": "JEAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-08",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024178166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEGAN",
            "last_name": "STAPLES",
            "middle_name": "JEAN",
            "credential": "PMHNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Halifax, VA

Sources for this page

Verify at the official NPI Registry.