Charlie Murphy Gantt, NP, AGPRN, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

4704317868 Issued in MI

Practice address

32905 W 12 Mile Rd
Farmington Hills, MI 48334-3342

Phone

(248) 957-9184

Fax

(248) 957-9185

NPI assigned

Apr 29, 2020

Last updated

May 8, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Alcona Citizens for Health IncGroup PAC ID 5991691958, shared by 16 NPIs, 65 clinicians

Counseling Center of West Michigan LLCGroup PAC ID 9234469255, 154 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: charlie.gantt.p1@direct.alcona.nextgenshare.com
• FHIR API: https://fhir4.healow.com/fhir/r4/EIBIBD

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

• Counseling Center of West Michigan, LLC

  • Mental Health Counselor
  • Grand Rapids, MI
  • NPI 1437610730
  Medicare reassignment Care Compare group NPD
• Advanced Veins and Vascular Management PLC

  • Vascular Surgery Physician
  • Hillsdale, MI
  • NPI 1972158566
  NPD (past)

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

{
    "created_epoch": "1588118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1346861440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1922 FOREST VIEW CT",
            "city": "COMMERCE TOWNSHIP",
            "state": "MI",
            "postal_code": "483903943",
            "telephone_number": "248-762-8017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32905 W 12 MILE RD",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483343342",
            "telephone_number": "248-957-9184",
            "fax_number": "248-957-9185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANTT",
        "first_name": "CHARLIE",
        "middle_name": "MURPHY",
        "credential": "NP, AGPRN, PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-29",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "4704317868",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MI",
            "license": "4704317868",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704317868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Gansert
• Patricia Ganski
• Carrington Elizabeth Gant
• Desiree Gant
• Jeanessa Gant
• Marcus Gantz
• Andrea Gaona
• Sierra Gaona
• Robert Gape
• Mavis Gappy

• Psychiatric/Mental Health Nurse Practitioner in Farmington Hills, MI
• Providers in Farmington Hills, MI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 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.