Individual provider Active NPI

Chrismene St Jean

  • Psychiatric/Mental Health Nurse Practitioner
  • Lake Worth, FL
National Provider Identifier
1114655446
Registry record updated Jul 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11020525 Issued in FL
Practice address
2328 10TH Ave N Ste 201
Lake Worth, FL 33461-6612
Phone
(561) 444-3771
NPI assigned
Aug 14, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X APRN11020525 FL Primary

Addresses

Primary practice location

2328 10TH Ave N Ste 201
Lake Worth, FL 33461-6612

Mailing address

2328 10TH Ave N Ste 201
Lake Worth, FL 33461-6612
Phone (561) 444-3771

Other identifiers 1

IdentifierTypeStateIssuer
01-OTHEROtherN/A

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240124002938 FL Practitioner - Nurse Practitioner 0446603690 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11020525FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rega Mental Health Center, LLC Single Specialty PastSince Feb 1, 2023 Accepting new patients
Broward Institute of Neuro Science L L C Single Specialty PastSince Feb 1, 2023 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1660435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1114655446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2328 10TH AVE N STE 201",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334616612",
            "telephone_number": "561-444-3771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2328 10TH AVE N STE 201",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334616612",
            "telephone_number": "561-444-3771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST JEAN",
        "first_name": "CHRISMENE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-14",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11020525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "N/A",
            "identifier": "01-OTHER",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

Verify at the official NPI Registry.