Individual provider Active NPI

Sharon Paulette Johnson Hyatt

  • Psychiatric/Mental Health Nurse Practitioner
  • Miramar, FL
National Provider Identifier
1396210555
Registry record updated Oct 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2686112 Issued in FL
Practice address
4225 SW 185TH Ave
Miramar, FL 33029-2777
Phone
(954) 801-6346
NPI assigned
Oct 3, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X 2686112 FL Primary

Addresses

Primary practice location

4225 SW 185TH Ave
Miramar, FL 33029-2777

Mailing address

4225 SW 185TH Ave
Miramar, FL 33029-2777
Phone (954) 801-6346

Other names 1

  • Mrs. Sharon Paulette Johnson Hyatt Professional name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190116001609 FL Practitioner - Nurse Practitioner 6103162912 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Solid Sobriety, LLCGroup PAC ID 0143552026, 4 clinicians
Complete Serenity IncGroup PAC ID 2466884911, 2 clinicians

Practice addresses (Care Compare)

721 E Atlantic Blvd
Pompano Beach, FL 33060-6345
Phone (954) 783-8300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2686112FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Complete Serenity Inc Single Specialty CurrentSince Oct 1, 2019 Accepting new patients
Solid Sobriety, LLC Single Specialty CurrentSince May 1, 2020 Accepting new patients
Coral Bay Recovery LLC Past Accepting new patients

Locations

721 E Atlantic Blvd
Pompano Beach, FL 33060
Phone (561) 808-9618

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1538524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538524800000",
    "number": "1396210555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4225 SW 185TH AVE",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330292777",
            "telephone_number": "954-801-6346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4225 SW 185TH AVE",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330292777",
            "telephone_number": "954-801-6346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON HYATT",
        "first_name": "SHARON",
        "middle_name": "PAULETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-03",
        "last_updated": "2018-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "2686112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHARON",
            "last_name": "JOHNSON HYATT",
            "middle_name": "PAULETTE",
            "prefix": "MRS.",
            "credential": "ARNP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Miramar, FL

Sources for this page

Verify at the official NPI Registry.