Active NPI
Charlie Health Medical PA
- Child & Adolescent Psychiatry Physician
- Sunrise, FL
National Provider Identifier
1013643261
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- Legal business name
- CHARLIE HEALTH MEDICAL PA
- Practice address
- 1560 Sawgrass Corporate Pkwy
Sunrise, FL 33323-2858 - Phone
- (406) 219-7835
- NPI assigned
- Jul 29, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ellen Broxmeyer
- Title
- Chief Compliance Officer
- Phone
- (720) 443-2529
Specialties & licenses 12
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Professional Counselor | 101YP2500X | |||
| Clinical Social Worker | 1041C0700X | |||
| Child & Adolescent Psychiatric/Mental Health Registered Nurse | 163WP0807X | |||
| Adult Psychiatric/Mental Health Registered Nurse | 163WP0809X | |||
| Psychiatry Physician | 2084P0800X | |||
| Addiction Psychiatry Physician | 2084P0802X | |||
| Child & Adolescent Psychiatry Physician | 2084P0804X | Primary | ||
| Adult Mental Health Clinic/Center | 261QM0850X | |||
| Adolescent and Children Mental Health Clinic/Center | 261QM0855X | |||
| Multi-Specialty Clinic/Center | 261QM1300X | |||
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X |
Addresses
Primary practice location
1560 Sawgrass Corporate Pkwy
Sunrise, FL 33323-2858
Mailing address
1925 Grand Ave Ste 129
PMB 85322
Billings, MT 59102
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Sunrise |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1659052800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1752710400000",
"number": "1013643261",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1925 GRAND AVE STE 129",
"address_2": "PMB 85322",
"city": "BILLINGS",
"state": "MT",
"postal_code": "59102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1560 SAWGRASS CORPORATE PKWY",
"city": "SUNRISE",
"state": "FL",
"postal_code": "333232858",
"telephone_number": "406-219-7835"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CHARLIE HEALTH MEDICAL PA",
"organizational_subpart": "NO",
"enumeration_date": "2022-07-29",
"last_updated": "2025-07-17",
"certification_date": "2025-07-17",
"status": "A",
"authorized_official_last_name": "BROXMEYER",
"authorized_official_first_name": "ELLEN",
"authorized_official_title_or_position": "CHIEF COMPLIANCE OFFICER",
"authorized_official_telephone_number": "720-443-2529"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "163WP0807X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
"state": null,
"license": null,
"primary": false
},
{
"code": "163WP0809X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0802X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Addiction Psychiatry",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": null,
"license": null,
"primary": true
},
{
"code": "261QM0850X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adult Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QM0855X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adolescent and Children Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QM1300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Multi-Specialty",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Sunrise",
"affiliation": "N",
"endpointDescription": "Office",
"address_1": "1560 Sawgrass Corporate Pkwy",
"city": "Sunrise",
"state": "FL",
"country_code": "US",
"postal_code": "333232858",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Sunrise, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.