Individual provider Active NPI

Micayla Charite, RBT

  • Other Technician
  • Port St Lucie, FL
National Provider Identifier
1649638032
Registry record updated Feb 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Other TechnicianTaxonomy code 247200000X
License
RBT-15-09265 Issued in FL
Practice address
1602 SE Walton Lakes Dr
Port St Lucie, FL 34952-5107
Phone
(772) 985-5353
NPI assigned
Feb 1, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Other Technician 247200000X RBT-15-09265 FL Primary

Addresses

Primary practice location

1602 SE Walton Lakes Dr
Port St Lucie, FL 34952-5107

Mailing address

1602 SE Walton Lakes Dr
Port St Lucie, FL 34952-5107
Phone (772) 985-5353

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RBT-15-09265FLMDOther Technician

NPI Registry JSON

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

{
    "created_epoch": "1454284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454284800000",
    "number": "1649638032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 SE WALTON LAKES DR",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349525107",
            "telephone_number": "772-985-5353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 SE WALTON LAKES DR",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349525107",
            "telephone_number": "772-985-5353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARITE",
        "first_name": "MICAYLA",
        "credential": "RBT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-01",
        "last_updated": "2016-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": "FL",
            "license": "RBT-15-09265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2016; 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.