Individual provider Active NPI

Charlene Desrosiers, APRN

  • Psychiatric/Mental Health Registered Nurse
  • Pompano Beach, FL
National Provider Identifier
1639856644
Registry record updated Jun 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
APRN11026885 Issued in FL
Practice address
1000 W McNab Rd
Pompano Beach, FL 33069-4719
Phone
(954) 440-7858
NPI assigned
Jun 30, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 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 Registered Nurse 163WP0808X APRN11026885 FL Primary

Addresses

Primary practice location

1000 W McNab Rd
Pompano Beach, FL 33069-4719

Mailing address

4337 NW 115TH Ave
Coral Springs, FL 33065-7161
Phone (954) 604-7725

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
I20240118003831 FL Practitioner - Nurse Practitioner 9931551595 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN11026885FLMDPsychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Re-Nu Mental Wellness Center CurrentSince Mar 1, 2026 Accepting new patients

Locations

160 Cypress Point Pkwy
Ste B302
Palm Coast, FL 32164
Phone (386) 230-4448

160 Cypress Point Pkwy
Ste 302
Palm Coast, FL 32164
Phone (815) 272-5813

1000 W McNab Rd
Pompano Beach, FL 33069
Phone (954) 440-7858

Organizations & group practices 1

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": "1688083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1639856644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4337 NW 115TH AVE",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330657161",
            "telephone_number": "954-604-7725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W MCNAB RD",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330694719",
            "telephone_number": "954-440-7858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESROSIERS",
        "first_name": "CHARLENE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-30",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11026885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pompano Beach, FL

Sources for this page

Verify at the official NPI Registry.