Petheree Nissley, FNP-C, PMHNP-BC is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Esmont, Virginia. Her current practice location is
2256 Irish Rd, Esmont, Virginia. You can reach out to her office (for appointments etc.) via phone at
(434) 286-3602.
Petheree Nissley is licensed to practice in Virginia (license number 0024173882) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1932656048.
Provider's Profile
| Full Name | Petheree Nissley |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Psychiatric/mental Health |
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| Location | 2256 Irish Rd, Esmont, Virginia |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1932656048
- Provider Enumeration Date: 09/07/2016
- Last Update Date: 01/19/2022
Medicare PECOS Information:
- PECOS PAC ID: 0941580427
- Enrollment ID: I20161130000664
Medical Identifiers
Medical identifiers for Petheree Nissley such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1932656048 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 0024173882 (Virginia) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 0024173882 (Virginia) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Petheree Nissley allows following entities to bill medicare on her behalf.
| Entity Name | Central Virginia Health Services Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1134258601
PECOS PAC ID: 0345158432
Enrollment ID: O20031119000823 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Petheree Nissley is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Petheree Nissley, FNP-C, PMHNP-BC
2256 Irish Rd,
Esmont, VA 22937-1945
Ph: () - | Petheree Nissley, FNP-C, PMHNP-BC
2256 Irish Rd,
Esmont, VA 22937-1945
Ph: (434) 286-3602 |
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