Individual provider Active NPI

Destiny Debora Coley Refuse, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Safety Harbor, FL
National Provider Identifier
1982250205
Registry record updated Sep 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11003699 Issued in FL
Practice address
100 Main St Ste 203
Safety Harbor, FL 34695-3668
Phone
(727) 799-4150
Fax
(727) 796-1845
NPI assigned
Aug 13, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11003699 FL Primary

Addresses

Primary practice location

100 Main St Ste 203
Safety Harbor, FL 34695-3668

Mailing address

100 Main St Ste 203
Safety Harbor, FL 34695-3668
Phone (727) 799-4150

Other identifiers 1

IdentifierTypeStateIssuer
106806700MedicaidFL

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20191001000066 FL Practitioner - Nurse Practitioner 4587994892 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Grow Healthcare Group PAGroup PAC ID 3476961368, 1,045 clinicians

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807
Phone (786) 244-7711

Merit-based Incentive Payment System (MIPS)

Final score
32.51 of 100Reported as group
Quality
0
Improvement activities
0
Cost
75.03

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Denori Psychiatry LLC Psychiatric/Mental Health Current Accepting new patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Mar 4, 2024 Accepting new patients
Kolettis Krew LLC PastSince Aug 16, 2019 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1565654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1982250205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MAIN ST STE 203",
            "city": "SAFETY HARBOR",
            "state": "FL",
            "postal_code": "346953668",
            "telephone_number": "727-799-4150",
            "fax_number": "727-796-1845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MAIN ST STE 203",
            "city": "SAFETY HARBOR",
            "state": "FL",
            "postal_code": "346953668",
            "telephone_number": "727-799-4150",
            "fax_number": "727-796-1845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REFUSE",
        "first_name": "DESTINY",
        "middle_name": "DEBORA COLEY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-13",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11003699",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106806700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Safety Harbor, FL

Sources for this page

Verify at the official NPI Registry.