Active NPI
John Charles Profera, APRN, BC
- Psychiatric/Mental Health Nurse Practitioner
- Jupiter, FL
National Provider Identifier
1164532974
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 2966762
- Practice address
- 725 N Highway A1A
Suite B106
Jupiter, FL 33477-4571 - Phone
- (561) 329-3642
- NPI assigned
- Aug 30, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 2966762 | FL | Primary |
Addresses
Primary practice location
725 N Highway A1A
Suite B106
Jupiter, FL 33477-4571
Mailing address
725 N Highway A1A
Suite B106
Jupiter, FL 33477-4571
Phone (561) 329-3642
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2966762 | FL | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1360800000000",
"number": "1164532974",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "725 N HIGHWAY A1A",
"address_2": "SUITE B106",
"city": "JUPITER",
"state": "FL",
"postal_code": "334774571",
"telephone_number": "561-329-3642"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "725 N HIGHWAY A1A",
"address_2": "SUITE B106",
"city": "JUPITER",
"state": "FL",
"postal_code": "334774571",
"telephone_number": "561-329-3642"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROFERA",
"first_name": "JOHN",
"middle_name": "CHARLES",
"name_prefix": "Mr.",
"credential": "APRN, BC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2013-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "FL",
"license": "2966762",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jupiter, FL
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.