Active NPI
Chris Dykhuisen
- School Psychologist
- Syracuse, IN
National Provider Identifier
1093532541
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 1616361
- Practice address
- 12799 N Kern Rd
Syracuse, IN 46567-1499 - Phone
- (574) 457-4484
- NPI assigned
- Sep 25, 2024
- Last updated
- Sep 25, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 1616361 | IN | Primary |
Addresses
Primary practice location
12799 N Kern Rd
Syracuse, IN 46567-1499
Mailing address
19474 Ozinga Dr
New Paris, IN 46553-9666
Other practice location 1
611 W Emeline St
Milford, IN 46542-9432
Phone (574) 658-9444
Other practice location 2
9850 N State Road 13
Syracuse, IN 46567-8294
Phone (574) 457-8839
Other practice location 3
1 Warrior Path Bldg 1
Syracuse, IN 46567-9170
Phone (574) 457-3147
Other practice location 4
801 S Sycamore St
Syracuse, IN 46567-1842
Phone (574) 457-3188
Other practice location 5
5745 N 750 E
North Webster, IN 46555-9227
Phone (574) 834-7644
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1616361 | IN | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1727222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727222400000",
"number": "1093532541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19474 OZINGA DR",
"city": "NEW PARIS",
"state": "IN",
"postal_code": "465539666"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12799 N KERN RD",
"city": "SYRACUSE",
"state": "IN",
"postal_code": "465671499",
"telephone_number": "574-457-4484"
}
],
"practiceLocations": [
{
"address_1": "611 W Emeline St",
"address_purpose": "LOCATION",
"city": "Milford",
"state": "IN",
"postal_code": "465429432",
"country_code": "US",
"telephone_number": "574-658-9444",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "9850 N State Road 13",
"address_purpose": "LOCATION",
"city": "Syracuse",
"state": "IN",
"postal_code": "465678294",
"country_code": "US",
"telephone_number": "574-457-8839",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1 Warrior Path Bldg 1",
"address_purpose": "LOCATION",
"city": "Syracuse",
"state": "IN",
"postal_code": "465679170",
"country_code": "US",
"telephone_number": "574-457-3147",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "801 S Sycamore St",
"address_purpose": "LOCATION",
"city": "Syracuse",
"state": "IN",
"postal_code": "465671842",
"country_code": "US",
"telephone_number": "574-457-3188",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5745 N 750 E",
"address_purpose": "LOCATION",
"city": "North Webster",
"state": "IN",
"postal_code": "465559227",
"country_code": "US",
"telephone_number": "574-834-7644",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DYKHUISEN",
"first_name": "CHRIS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-09-25",
"last_updated": "2024-09-25",
"certification_date": "2024-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "IN",
"license": "1616361",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Syracuse, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.