Charity Nikole Roseberry, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

195360 Issued in GA

Practice address

110 Braxton CT
Fayetteville, GA 30214-1968

Phone

(770) 461-3065

NPI assigned

Jul 24, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1563926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563926400000",
    "number": "1710530134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 ANTEBELLUM WAY",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302155056",
            "telephone_number": "901-326-7760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 BRAXTON CT",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141968",
            "telephone_number": "770-461-3065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEBERRY",
        "first_name": "CHARITY",
        "middle_name": "NIKOLE",
        "name_prefix": "Mrs.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-24",
        "last_updated": "2019-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "195360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Orossica Rodney
• Kim Martinet Rolle, PHARM.D.
• Mikayla Rolle, MSOT
• Emma Romigh, PA
• Rose'S Hands
• Leslie Rosenblatt-Brown, PA-C
• Jacqueline Denise Ross, CRNP
• Jose Rossello, MD
• Lacrecia Rosser, OTR/L
• Decheyla Rouse

• Psychiatric/Mental Health Nurse Practitioner in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2019; 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.