NPIMap

Organization Active NPI

CGR Beacon Clinic, PA

  • Professional Counselor
  • Port Charlotte, FL
National Provider Identifier
1841220811
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
ARNP2935382 Issued in FL
Legal business name
CGR BEACON CLINIC, PA
Doing business as
CGR Beacon Clinic, PA
Practice address
3782 Tamiami TRL
Port Charlotte, FL 33952-8353
Phone
(941) 629-7855
Fax
(941) 629-9589
NPI assigned
Jul 4, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Charlene Joan Rosenfield, ARNPNPI 1295778835
Title
Arnp
Phone
(941) 629-7855

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X ARNP2935382 FL Primary

Addresses

Primary practice location

3782 Tamiami TRL
Port Charlotte, FL 33952-8353

Mailing address

PO Box 496080
Port Charlotte, FL 33949-6080
Phone (941) 629-7855

Other names 1

  • CGR Beacon Clinic, PA Doing business as

National Provider Directory

National Provider Directory

Locations

3782 Tamiami Trl
Port Charlotte, FL 33952
Phone (941) 629-7855

3782 Tamiami Trl
Ste A
Pt Charlotte, FL 33952
Phone (941) 629-7855

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841220811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 496080",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339496080",
            "telephone_number": "941-629-7855",
            "fax_number": "941-629-9589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3782 TAMIAMI TRL",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339528353",
            "telephone_number": "941-629-7855",
            "fax_number": "941-629-9589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CGR BEACON CLINIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROSENFIELD",
        "authorized_official_first_name": "CHARLENE",
        "authorized_official_middle_name": "JOAN",
        "authorized_official_title_or_position": "ARNP",
        "authorized_official_telephone_number": "941-629-7855",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "FL",
            "license": "ARNP2935382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CGR Beacon Clinic, PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.