Individual provider Active NPI

Nicole Elise Libert, PMHNP, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Columbia, TN
National Provider Identifier
1578285557
Registry record updated Nov 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
32661 Issued in TN
Practice address
100 Berrywood Dr
Columbia, TN 38401-6408
Phone
(866) 816-0433
NPI assigned
Sep 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2022

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 32661 TN Primary

Addresses

Primary practice location

100 Berrywood Dr
Columbia, TN 38401-6408

Mailing address

275 Cumberland BND
Nashville, TN 37228-1805
Phone (615) 726-3340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20221117002141 TN Practitioner - Nurse Practitioner 4688042914 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Care Center LLCGroup PAC ID 5991064420, 703 clinicians

Practice addresses (Care Compare)

500 28TH Ave N
Suite 210
Nashville, TN 37209-4456
Phone (888) 374-5066

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
32661TNMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Center, LLC CurrentSince Nov 2, 2024 Accepting new patients
Mental Health Cooperative, Inc CurrentSince Nov 2, 2022 Accepting new patients
Family Care Center, LLC Psychiatric/Mental Health CurrentSince Nov 2, 2024 Accepting new patients

Locations

100 Berrywood Dr
Columbia, TN 38401
Phone (615) 726-3340

5030 Carothers Pkwy
Ste 120
Franklin, TN 37067
Phone (615) 534-2176

275 Cumberland Bnd
Nashville, TN 37228
Phone (615) 726-3340

500 28th Ave N
Ste 210
Nashville, TN 37209
Phone (615) 208-2908

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15315/brand/1/csg/1/fhir/r4

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": "1663200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667520000000",
    "number": "1578285557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 CUMBERLAND BND",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372281805",
            "telephone_number": "615-726-3340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BERRYWOOD DR",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384016408",
            "telephone_number": "866-816-0433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIBERT",
        "first_name": "NICOLE",
        "middle_name": "ELISE",
        "credential": "PMHNP, APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-15",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "32661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, TN

Sources for this page

Verify at the official NPI Registry.