Mary Yates Codrick, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

11023498 Issued in FL

Practice address

9729 Faraway Farm Rd
Tallahassee, FL 32317-1603

Phone

(850) 294-4978

NPI assigned

Mar 31, 2023

Sex

Female

Sole proprietor

Yes

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

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Harmony United Florida, LLCGroup PAC ID 9638306673, 86 clinicians

Chrysalis Center, Inc.Group PAC ID 8325186646, 36 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Chrysalis Center, LLC

  • Community/Behavioral Health Agency
  • Fort Lauderdale, FL
  • NPI 1700961646
  Medicare reassignment Care Compare group NPD
• Harmony United Florida, LLC

  • Psychiatry Physician
  • Winter Garden, FL
  • NPI 1063842870
  Medicare reassignment Care Compare group
• Florida Therapy Services, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Pensacola, FL
  • NPI 1407427800
  NPD

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

{
    "created_epoch": "1680220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680220800000",
    "number": "1720783780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9729 FARAWAY FARM RD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323171603",
            "telephone_number": "850-294-4978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9729 FARAWAY FARM RD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323171603",
            "telephone_number": "850-294-4978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CODRICK",
        "first_name": "MARY",
        "middle_name": "YATES",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-31",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11023498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cobalt Wellness LLC
• Alicia Cobb, MSW
• Jennifer Guemple Cobb
• Justin Cobb
• Dan D. Cober, DMD
• Julia Coelho
• Sven Arnold Coetzee, L.M.H.C.
• Keshia Latoya Coffie, MPA, MSW
• Kaylee May Cofield, PA-C
• Heidi Coggins, RCSWI

• Psychiatric/Mental Health Nurse Practitioner in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.