Individual provider Active NPI

Jennifer Rose

  • Psychiatric/Mental Health Nurse Practitioner
  • North Miami Beach, FL
National Provider Identifier
1518690379
Registry record updated Sep 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2022028628 Issued in FL
Practice address
1001 N Miami Beach Blvd
North Miami Beach, FL 33162-3842
Phone
(786) 320-5559
Fax
(786) 796-1021
NPI assigned
Jul 7, 2022
Last updated
Sep 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11020745 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2022028628 FL Primary

Addresses

Primary practice location

1001 N Miami Beach Blvd
North Miami Beach, FL 33162-3842

Mailing address

PO Box 267186
Weston, FL 33326-7186
Phone (786) 320-5559

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
I20240731004311 FL Practitioner - Nurse Practitioner 1052858669 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
G.R.O.W.T.H. Counseling and TherapyGroup PAC ID 8820401870, 2 clinicians

Practice addresses (Care Compare)

1001 N Miami Beach Blvd
North Miami Beach, FL 33162-3842
Phone (718) 785-6367

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11020745FLMDPsychiatric/Mental Health Nurse Practitioner
2022028628FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Jezreel Company LLC CurrentSince Feb 26, 2023 Accepting new patients
G.R.O.W.T.H. Counseling and Therapy CurrentSince Aug 10, 2024 Accepting new patients
David Lawrence Mental Health Center, Inc CurrentSince Jun 22, 2024 Accepting new patients

Locations

6075 Bathey Ln
Naples, FL 34116
Phone (239) 455-8500

1001 N Miami Beach Blvd
North Miami Beach, FL 33162
Phone (718) 785-6367

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1657152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726272000000",
    "number": "1518690379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 267186",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333267186",
            "telephone_number": "786-320-5559",
            "fax_number": "786-796-1021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 N MIAMI BEACH BLVD",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331623842",
            "telephone_number": "786-320-5559",
            "fax_number": "786-796-1021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-07",
        "last_updated": "2024-09-14",
        "certification_date": "2024-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11020745",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "2022028628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Miami Beach, FL

Sources for this page

Verify at the official NPI Registry.