Sara Waterbury, DNP, PMHNP-BC, RN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APRN11022114 Issued in FL

Practice address

1680 SW Bayshore Blvd Ste 107
Port St Lucie, FL 34984-3518

Phone

(772) 249-2597

NPI assigned

Oct 25, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

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.

• Broken Roads Mental Health, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Port St Lucie, FL
  • NPI 1164259974
  Medicare reassignment NPD Authorized official
• Geo Care, Inc.

  • Psychiatric Hospital
  • Indiantown, FL
  • NPI 1750666053
  NPD (past)

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

{
    "created_epoch": "1666656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1316664956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 BEACH AVE",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349521371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 SW BAYSHORE BLVD STE 107",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349843518",
            "telephone_number": "772-249-2597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERBURY",
        "first_name": "SARA",
        "credential": "DNP, PMHNP-BC, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-25",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9392585",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11022114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Warren Yazji Associates DDS PA
• Joshua Bernard Warren Sr.
• Loel Scott Warsch, MD
• Justin D Wasdin, PA-C
• Trenise Washington
• Laurence Octavius Watkins, MD
• Corinne Arrington Watson, MD
• Cherie Sharese Watts, D.C
• Katie Watts
• Wave Family Services

• Psychiatric/Mental Health Nurse Practitioner in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.