NPIMap

Organization Active NPI

Friar Psychiatric Services LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Riverview, FL
National Provider Identifier
1740947928
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
FRIAR PSYCHIATRIC SERVICES LLC
Practice address
11968 Balm Riverview Rd
Riverview, FL 33569-6601
Phone
(813) 819-3335
Fax
(866) 885-1512
NPI assigned
Nov 22, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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

Authorized official

Name
Trevon Jarrod Friar, PMHNP-BCNPI 1689291726
Title
Owner
Phone
(386) 299-0045

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

11968 Balm Riverview Rd
Riverview, FL 33569-6601

Mailing address

11412 Acacia Grove LN
Riverview, FL 33579-8412
Phone (386) 299-0045

Other identifiers 1

IdentifierTypeStateIssuer
112746000MedicaidFL

Other names 1

  • Pivoting Minds Psychiatry Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220131001409 FL Part B Supplier - Clinic/Group Practice 2860885696 Receives reassigned benefits from 5 practitioners
Practice locations: Riverview, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1637539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706659200000",
    "number": "1740947928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11412 ACACIA GROVE LN",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335798412",
            "telephone_number": "386-299-0045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11968 BALM RIVERVIEW RD",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335696601",
            "telephone_number": "813-819-3335",
            "fax_number": "866-885-1512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRIAR PSYCHIATRIC SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-22",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A",
        "authorized_official_last_name": "FRIAR",
        "authorized_official_first_name": "TREVON",
        "authorized_official_middle_name": "JARROD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-299-0045",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112746000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pivoting Minds Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Riverview, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.