Individual provider Active NPI

Hidelisse Charris, ARNP

  • Nurse Practitioner
  • West Palm Beach, FL
National Provider Identifier
1710281415
Registry record updated Apr 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP11007005 Issued in FL
Practice address
1150 45TH St
West Palm Beach, FL 33407-2361
Phone
(561) 514-5300
Fax
(561) 514-5538
NPI assigned
Jan 10, 2011
Last updated
Apr 13, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP11007005 FL Primary

Addresses

Primary practice location

1150 45TH St
West Palm Beach, FL 33407-2361

Mailing address

800 Clematis St Ste 5-531
West Palm Beach, FL 33401-5107
Phone (561) 671-4036

Other practice location 1

800 Clematis St Ste 5-531
West Palm Beach, FL 33401-5107
Phone (561) 671-4036

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP11007005FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Department of Health PastSince Feb 14, 2021 Accepting new patients
Florida Department of Health Past Accepting new patients

Organizations & group practices 2

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": "1294617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649808000000",
    "number": "1710281415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 CLEMATIS ST STE 5-531",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334015107",
            "telephone_number": "561-671-4036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 45TH ST",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334072361",
            "telephone_number": "561-514-5300",
            "fax_number": "561-514-5538"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Clematis St Ste 5-531",
            "address_purpose": "LOCATION",
            "city": "West Palm Beach",
            "state": "FL",
            "postal_code": "334015107",
            "country_code": "US",
            "telephone_number": "561-671-4036",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHARRIS",
        "first_name": "HIDELISSE",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-10",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP11007005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.