Ozzie Amenda Hairston, DNP, PMHNP in Charlotte, NC

Ozzie Amenda Hairston, DNP, PMHNP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Charlotte, North Carolina. Her current practice location is 4111 Rose Lake Dr Ste 8922, Charlotte, North Carolina. You can reach out to her office (for appointments etc.) via phone at (281) 406-1112.

Ozzie Amenda Hairston is licensed to practice in Texas (license number 1012284) 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 1588893978.

Contact Information

	Ozzie Amenda Hairston, DNP, PMHNP
	4111 Rose Lake Dr Ste 8922, Charlotte, NC 28217-2829
	(281) 406-1112
	(713) 583-2081

Map and Direction

Provider's Profile

Full Name	Ozzie Amenda Hairston
Gender	Female
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	4111 Rose Lake Dr Ste 8922, Charlotte, North Carolina
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1588893978
Provider Enumeration Date: 07/07/2009
Last Update Date: 09/18/2025

Medicare PECOS Information:

PECOS PAC ID: 5698133478
Enrollment ID: I20230627001072

Medical Identifiers

Medical identifiers for Ozzie Amenda Hairston such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1588893978	NPI	-	NPPES
1012284	Other	TX	TEXAS STATE 1012284

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	AP61379476 (Washington)	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	1012284 (Texas)	Primary
163W00000X	Registered Nurse	RN61379474 (Washington)	Secondary

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. Ozzie Amenda Hairston allows following entities to bill medicare on her behalf.

Entity Name	Houston Psychiatry Healthcare Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1063852721 PECOS PAC ID: 2466689039 Enrollment ID: O20131206000475

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. Ozzie Amenda Hairston 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
Ozzie Amenda Hairston, DNP, PMHNP 4526 Federal Ave, Everett, WA 98203-2132 Ph: (425) 349-6200	Ozzie Amenda Hairston, DNP, PMHNP 4111 Rose Lake Dr Ste 8922, Charlotte, NC 28217-2829 Ph: (281) 406-1112

Reviews and Comments

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Ozzie Amenda Hairston, DNP, PMHNP - Medicare Nurse Practitioner in Charlotte, NC