Beachfront Internal Medicine and Mental Health Clinic LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

BEACHFRONT INTERNAL MEDICINE AND MENTAL HEALTH CLINIC LLC

Practice address

33759 Clay Rd Unit 2
Lewes, DE 19958-6294

Phone

(302) 236-4694

NPI assigned

Oct 4, 2023

Last updated

Jan 30, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Joanna Robertson, DNPNPI 1619483427

Title

Owner

Phone

(302) 236-4694

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in DE

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Joanna Robertson, FNP

  • Nurse Practitioner
  • Lewes, DE
  • NPI 1619483427

  Family

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1696377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706572800000",
    "number": "1326828401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 MORGAN WAY",
            "city": "MILTON",
            "state": "DE",
            "postal_code": "199681151",
            "telephone_number": "302-236-4694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33759 CLAY RD UNIT 2",
            "city": "LEWES",
            "state": "DE",
            "postal_code": "199586294",
            "telephone_number": "302-236-4694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACHFRONT INTERNAL MEDICINE AND MENTAL HEALTH CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-04",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-26",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "JOANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "302-236-4694",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Lewes, DE
• Providers in Lewes, DE by specialty
• Psychiatric/Mental Health Nurse Practitioner in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.