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PHOENIXMIDES MENTAL HEALTH & WELLNESS
NPI 1023896586
Nurse Practitioner - Psychiatric/Mental Health in Petersburg, VA

Active since September 18, 2023
591 OAKWOOD CIR, PETERSBURG, VA 23805(540) 204-2459 Get Directions Write a Review

NPPES record last updated: February 12, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Phoenixmides Mental Health & Wellness NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PHOENIXMIDES MENTAL HEALTH & WELLNESS (NPI 1023896586) is a healthcare organization registered as a psychiatric/mental health in Petersburg, Virginia and active in the NPI registry since September 2023. The organization lists Oluwaseyi Oladipupo Soetan, Psychiatric Nurse Practitioner, as its authorized official.

NPPES Registry Identity

NPI1023896586
Entity TypeOrganization
Primary Taxonomy363LP0808X
Legal Business NamePHOENIXMIDES LLC
Location Address591 OAKWOOD CIRPetersburg, VA 23805-9339
Mailing Address5706 Gossamer CtMoseley, VA 23120-2339 · (154) 020-4245
Phone(540) 204-2459
Organization SubpartNo
Authorized OfficialOluwaseyi Oladipupo SoetanPsychiatric Nurse Practitioner · (540) 204-2459
Enumeration DateSeptember 18, 2023
Last NPPES UpdateFebruary 12, 2024
NPPES CertifiedFebruary 12, 2024
✔ NPI 1023896586 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
591 OAKWOOD CIR, Petersburg, VA 23805
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Other Names 1

Doing Business AsPhoenixmides Mental Health & Wellness

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Phoenixmides LLC's NPI number?

The NPI number for Phoenixmides LLC is 1023896586. It was assigned to this organization in the NPPES registry on September 18, 2023. The provider is doing business as Phoenixmides Mental Health & Wellness.

Where is Phoenixmides LLC located?

Phoenixmides LLC is located at 591 Oakwood Cir, Petersburg, VA 23805. The listed phone number is (540) 204-2459.

What is Phoenixmides LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

When was this NPI record last updated?

The NPPES record for Phoenixmides LLC was last updated on February 12, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.