Panacea Behavioral Health & Wellness Center – Psychiatric/Mental Health Nurse Practitioner, NPI 1801489711
Psychiatric/Mental Health Nurse Practitioner
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Panacea Behavioral Health & Wellness Center
4360 SHORE DR STE 101
VIRGINIA BEACH, VA 234552994
Phone: (757) 251-0879
Fax: (984) 220-9437
Type: Mailing
1611 E Joy Ln Ste 1
Fort Mohave, AZ 864268940
Phone: (757) 251-0879
Fax: (984) 220-9437
Type: Location
857 E Park Ave
Tallahassee, FL 323012620
Phone: (757) 251-0879
Fax: (984) 220-9437
Type: Location
1700 PLEASURE HOUSE RD STE 102A
VIRGINIA BEACH, VA 234554062
Phone: (757) 251-0879
Fax: (984) 220-9437
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2026-03-12
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Revalidation due soon
Earliest CMS due date is 2026-07-31 (50 days away).
Enrollment records
3
Earliest due date
2026-07-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20210707003787 | O | Clinic/Group Practice | VA | 2026-07-31 |
| O20210820001396 | O | Clinic/Group Practice | AZ | TBD |
| O20260312001371 | O | Clinic/Group Practice | FL | TBD |
What to do next
- Confirm the due date on the CMS Revalidation Lookup Tool.
- Complete revalidation in PECOS before the published due date.
- If you have multiple enrollment records, revalidate each one on its own schedule.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 23455)
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