Individual provider Active NPI

Jeanmarie Roberts, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1689849671
Registry record updated May 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
5004323 Issued in NC
Practice address
15720 Brixham Hill Ave Ste 300
Charlotte, NC 28277-4784
Phone
(800) 465-3203
NPI assigned
Apr 29, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X 175884 NC
Psychiatric/Mental Health Clinical Nurse Specialist 364SP0808X 175884 NC
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5004323 NC Primary
Clinical Nurse Specialist 364S00000X 175884 NC

Addresses

Primary practice location

15720 Brixham Hill Ave Ste 300
Charlotte, NC 28277-4784

Mailing address

6056 Charing PL
Charlotte, NC 28211-4323
Phone (704) 517-6634

Other practice location 1

6056 Charing Pl
Charlotte, NC 28211-4323
Phone (704) 517-6634

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20090514000269 NC Practitioner - Nurse Practitioner 2860541299 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5004323NCMDPsychiatric/Mental Health Nurse Practitioner
175884NCMDClinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Oct 8, 2024 Accepting new patients
Catawba Valley Medical Center Past Accepting new patients
Catawba Valley Medical Center PastSince Jul 9, 2012 Accepting new patients
University Psychiatric Associates P.a. Past Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

3511 Shannon Rd
Fl 3
Durham, NC 27707
Phone (201) 293-7689

Organizations & group practices 4

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": "1209427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779667200000",
    "number": "1689849671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6056 CHARING PL",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282114323",
            "telephone_number": "704-517-6634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15720 BRIXHAM HILL AVE STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282774784",
            "telephone_number": "800-465-3203"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6056 Charing Pl",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282114323",
            "country_code": "US",
            "telephone_number": "704-517-6634",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "JEANMARIE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-29",
        "last_updated": "2026-05-25",
        "certification_date": "2026-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "175884",
            "primary": false
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "NC",
            "license": "175884",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5004323",
            "primary": true
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "NC",
            "license": "175884",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.