Gumtree Mental Health & Wellness

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

GUMTREE MENTAL HEALTH & WELLNESS

Practice address

520 Fullerton Rd Ste B
Swansea, IL 62226-2901

Phone

(618) 277-0006

NPI assigned

Sep 9, 2024

Organization subpart

No

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

Authorized official

Name

Kyria A Buchanan, PMHNP-BC, APRNNPI 1629654298

Title

Nurse Practitioner

Phone

(813) 838-2707

Specialties & licenses 1

Addresses

Practitioners 1

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

• Kyria Anastasia Buchanan, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Swansea, IL
  • NPI 1629654298
  NPD Authorized official

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

{
    "created_epoch": "1725840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725840000000",
    "number": "1023844909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 N LINCOLN AVE",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691322",
            "telephone_number": "813-838-2707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 FULLERTON RD STE B",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622262901",
            "telephone_number": "618-277-0006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUMTREE MENTAL HEALTH & WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-09",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A",
        "authorized_official_last_name": "BUCHANAN",
        "authorized_official_first_name": "KYRIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "813-838-2707",
        "authorized_official_credential": "PMHNP-BC, APRN"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laurie Jansen Gray, LCSW
• Antonette Marie Green, LPC
• James Franklin Gregory, M.D.
• Emily Grimes
• Halli Gruberman
• Kreg Ryan Gunter, DC
• Laura Lorraine Hackworth, APRN,CNP
• Lisa Hager, O.D.
• Elizabeth Angela Haldeman, M.S.
• Diandra Danielle Hall, BA, MA, LPC

• Psychiatric/Mental Health Nurse Practitioner in Swansea, IL
• Providers in Swansea, IL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; 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.