MOSAIC CARE CENTER
NPI 1104170398
Nurse Practitioner - Family in Fredericksburg, VA

Q: What is Fredericksburg Area Health And Support Services's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Active since November 09, 2012

10514 WAKEMAN DR, FREDERICKSBURG, VA 22407(540) 907-4555(833) 918-2314 Get Directions Write a Review

NPPES record last updated: August 30, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 30, 2022, Aug 18, 2022, Sep 28, 2021 and 2 more (5 updates tracked since 2016).

On this page

About Mosaic Care Center NPPES

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

MOSAIC CARE CENTER (NPI 1104170398) is a healthcare organization registered as a family in Fredericksburg, Virginia and active in the NPI registry since November 2012. The organization maintains 3 additional practice locations and lists Joseph Lyttle, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1104170398

Entity TypeOrganization

Primary Taxonomy363LF0000X

Legal Business NameFREDERICKSBURG AREA HEALTH AND SUPPORT SERVICES

Location Address10514 WAKEMAN DRFredericksburg, VA 22407-8040

Mailing Address4343 Plank Rd Ste 100Fredericksburg, VA 22407-4807 · (540) 907-4555 · Fax (540) 907-4318

Phone(540) 907-4555

Fax(833) 918-2314

Organization SubpartNo

Authorized OfficialJoseph LyttleExecutive Director · (540) 907-4555

Enumeration DateNovember 9, 2012

Last NPPES UpdateAugust 30, 20225 updates tracked since enumeration

NPPES CertifiedAugust 30, 2022

✔ NPI 1104170398 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 14

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

Also ListedSocial WorkerTaxonomy 104100000X

Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X

Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X

Also ListedPeer SpecialistTaxonomy 175T00000X

Also ListedCase ManagementTaxonomy 251B00000X

Also ListedPublic Health or WelfareTaxonomy 251K00000X

Also ListedCommunity/Behavioral HealthTaxonomy 251S00000X

Also ListedClinic/CenterTaxonomy 261Q00000X

Also ListedClinic/Center · Primary CareTaxonomy 261QP2300X

Also ListedNurse Practitioner · Psychiatric/Mental HealthTaxonomy 363LP0808X

Also ListedClinical Nurse Specialist · Adult HealthTaxonomy 364SA2200X

Also ListedClinical Nurse Specialist · Family HealthTaxonomy 364SF0001X

Also ListedClinical Nurse Specialist · Psychiatric/Mental Health, AdultTaxonomy 364SP0809X

10514 WAKEMAN DR, Fredericksburg, VA 22407

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Other Names 1

Doing Business AsMosaic Care Center

Secondary Practice Locations 3

Location 14343 Plank Rd Ste 110Fredericksburg, VA 22407-4807 · Phone (540) 907-4555 · Fax (540) 907-4318

Location 2219 E Davis St Ste 100Culpeper, VA 22701-3005 · Phone (540) 907-4555

Location 3415 Elm StFredericksburg, VA 22401-3313 · Phone (540) 907-4555

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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mosaic Care Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 4 clinicians reassign Medicare billing to Mosaic Care Center, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (4)

Ashley Tyler, FNP

Nurse Practitioner

NPI 1063035632

10514 WAKEMAN DR
Fredericksburg, VA 22407

(540) 419-6888

✔ PECOS✔ Accepts MedicareSame address

Mara Dominguez, NP-C

Nurse Practitioner

NPI 1700268745

2740 BENSLEY COMMONS BLVD
North Chesterfield, VA 23237

(804) 780-0840

✔ PECOS57 mi

Seqouia Pettigrew

Mental Health Counselor

NPI 1730859869

2150 COUNTRY CLUB RD STE 228
Winston Salem, NC 27104

(855) 284-7483

✔ PECOS✔ Accepts Medicare213 mi

Crystal Miller Williams, NP

Nurse Practitioner

NPI 1750634770

5012 S US HIGHWAY 75
Denison, TX 75020

(903) 416-6010

✔ PECOS✔ Accepts Medicare1,111 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Fredericksburg Area Health And Support Services's NPI number?

The NPI number for Fredericksburg Area Health And Support Services is 1104170398. It was assigned to this organization in the NPPES registry on November 9, 2012. The provider is doing business as Mosaic Care Center.

Where is Fredericksburg Area Health And Support Services located?

Fredericksburg Area Health And Support Services is located at 10514 Wakeman Dr, Fredericksburg, VA 22407. The listed phone number is (540) 907-4555.

What is Fredericksburg Area Health And Support Services's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Fredericksburg Area Health And Support Services enrolled in Medicare?

Yes. Fredericksburg Area Health And Support Services is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Fredericksburg Area Health And Support Services?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians in 2 Medicare specialties reassign their Medicare billing to Fredericksburg Area Health And Support Services. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (3) and Mental Health Counselor (1). Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Fredericksburg Area Health And Support Services was last updated on August 30, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.