Individual provider Active NPI

Christine Brewer, BSN, RN, MSN, PMH-NP

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1487061370
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
402105 Issued in NY
Practice address
2090 Adam Clayton Powell Jr Blvd FL 7
New York, NY 10027-4990
Phone
(917) 485-7276
NPI assigned
Jul 13, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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 Practitioner 363LP0808X 402105 NY Primary

Addresses

Primary practice location

2090 Adam Clayton Powell Jr Blvd FL 7
New York, NY 10027-4990

Mailing address

2090 Adam Clayton Powell Jr Blvd FL 7
New York, NY 10027-4990
Phone (179) 485-7276

Other practice location 1

510 E 20th St Apt 8E
New York, NY 10009-8305
Phone (203) 247-1123

Other identifiers 1

IdentifierTypeStateIssuer
402105OtherNYNP LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
402105NYMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1405209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1487061370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2090 ADAM CLAYTON POWELL JR BLVD FL 7",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100274990",
            "telephone_number": "179-485-7276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2090 ADAM CLAYTON POWELL JR BLVD FL 7",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100274990",
            "telephone_number": "917-485-7276"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "510 E 20th St Apt 8E",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100098305",
            "country_code": "US",
            "telephone_number": "203-247-1123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BREWER",
        "first_name": "CHRISTINE",
        "credential": "BSN, RN, MSN, PMH-NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-13",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "402105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP LICENSE NUMBER",
            "identifier": "402105",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.