Johari Patrice Faison, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APRN11016744 Issued in FL

Practice address

725 N 12TH Ave
Arcadia, FL 34266-8752

Phone

(863) 494-1242

Fax

(863) 491-0466

NPI assigned

Feb 21, 2022

Last updated

Mar 1, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

MCR Health IncGroup PAC ID 7214847995, 132 clinicians

North Brevard Medical Support IncGroup PAC ID 7618870296, 62 clinicians

Sunrise Counseling Services PLLCGroup PAC ID 4385181759, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Parrish Medical Center Hospital, Titusville, FL, CCN 100028

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: johari.faison.1@17832.direct.athenahealth.com

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.

• MCR Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Parrish, FL
  • NPI 1255376000
  Medicare reassignment Care Compare group NPD
• North Brevard Medical Support, Inc

  dba Parrish Medical Group

  • Multi-Specialty Clinic/Center
  • Titusville, FL
  • NPI 1609834886
  Medicare reassignment Care Compare group NPD
• Sunrise Counseling Services, PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Clermont, FL
  • NPI 1710624101
  Medicare reassignment Care Compare group NPD
• Ace Behavioral Health LLC

  • Psychiatry Physician
  • Tampa, FL
  • NPI 1841094885

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Citrus County Rural Health Inc

  • Federally Qualified Health Center (FQHC)
  • Crystal River, FL
  • NPI 1740931831
  Medicare reassignment NPD
• Coastal Community Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Fernandina Beach, FL
  • NPI 1851131874
  Medicare reassignment
• MCR Health, Inc.

  dba Riverside Medical Center

  • Non-Pharmacy Dispensing Site
  • Bradenton, FL
  • NPI 1821878745
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• North Brevard County Hospital District

  dba Parrish Medical Center

  • General Acute Care Hospital
  • Titusville, FL
  • NPI 1053424648
  Care Compare affiliation

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

{
    "created_epoch": "1645401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646092800000",
    "number": "1386399095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 8TH AVE W STE 101",
            "city": "PALMETTO",
            "state": "FL",
            "postal_code": "342214737",
            "telephone_number": "941-776-4000",
            "fax_number": "941-845-4963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 N 12TH AVE",
            "city": "ARCADIA",
            "state": "FL",
            "postal_code": "342668752",
            "telephone_number": "863-494-1242",
            "fax_number": "863-491-0466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAISON",
        "first_name": "JOHARI",
        "middle_name": "PATRICE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-21",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11016744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elite Mobile Lab Services, LLC
• Charles W. Elwell III, DMD
• Lenora Juanita Enix, PSY.D.
• Erica Escamilla, APRN
• Kyle L Fairchild, ARNP
• Family Care Medical Center II LLC (Family Care Medical Center)
• Family Care Medical Center II LLC (Family Care Medical Center)
• Deborah J Fantin, DO
• Deanna Lynn Feher, LCSW
• Jessica Alexandra Fennell-Thomas, APRN

• Psychiatric/Mental Health Nurse Practitioner in Arcadia, FL
• Providers in Arcadia, 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 Mar 1, 2022; 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.