Active NPI
Sycamore Springs, LLC
Doing business as Sycamore Springs
- Psychiatry Physician
- Lafayette, IN
National Provider Identifier
1235568734
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 01044028B
- Legal business name
- SYCAMORE SPRINGS, LLC
- Doing business as
- Sycamore Springs
- Practice address
- 833 Park East Blvd
Lafayette, IN 47905-0785 - Phone
- (765) 743-4400
- Fax
- (765) 743-4411
- NPI assigned
- Nov 5, 2013
- Organization subpart
- Yes
- Parent organization
- SYCAMORE SPRINGS, LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Donna Salee West, RN
- Title
- Director of License and Regulation
- Phone
- (812) 598-8989
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 01044009A | IN | |
| Family Medicine Physician | 207Q00000X | 02002841A | IN | |
| Psychiatry Physician | 2084P0800X | 01044028B | IN | Primary |
| Adult Health Nurse Practitioner | 363LA2200X | 28150957A | IN | |
| Family Nurse Practitioner | 363LF0000X | 28119850A | IN |
Addresses
Primary practice location
833 Park East Blvd
Lafayette, IN 47905-0785
Mailing address
833 Park East Blvd
Lafayette, IN 47905-0785
Phone (765) 743-4400
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01044009A | Other | IN | LICENSE NUMBER |
| 02002841A | Other | IN | LICENSE NUMBER |
| 28119850A | Other | IN | LICENSE NUMBER |
| 28150957A | Other | IN | LICENSE NUMBER |
| 01044028B | Other | IN | LICENSE NUMBER |
Other names 1
- Sycamore Springs
National Provider Directory
National Provider Directory- Part of
- Sycamore Springs LLC
Locations
7666 Solutions Ctr
Chicago, IL 60677
Ownership & related parties
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
-
dba Sycamore Springs Hospital, LLC
- Psychiatric Hospital
- Lafayette, IN
- NPI 1477832772
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Professional Counselor
- Chicago, IL
- NPI 1215604509
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383609600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1383609600000",
"number": "1235568734",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "833 PARK EAST BLVD",
"city": "LAFAYETTE",
"state": "IN",
"postal_code": "479050785",
"telephone_number": "765-743-4400",
"fax_number": "765-743-4411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "833 PARK EAST BLVD",
"city": "LAFAYETTE",
"state": "IN",
"postal_code": "479050785",
"telephone_number": "765-743-4400",
"fax_number": "765-743-4411"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SYCAMORE SPRINGS, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "SYCAMORE SPRINGS, LLC",
"enumeration_date": "2013-11-05",
"last_updated": "2013-11-05",
"status": "A",
"authorized_official_last_name": "WEST",
"authorized_official_first_name": "DONNA",
"authorized_official_middle_name": "SALEE",
"authorized_official_title_or_position": "DIRECTOR OF LICENSE AND REGULATION",
"authorized_official_telephone_number": "812-598-8989",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "RN"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "IN",
"license": "01044009A",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "IN",
"license": "02002841A",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IN",
"license": "01044028B",
"primary": true
},
{
"code": "363LA2200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Adult Health",
"state": "IN",
"license": "28150957A",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": "IN",
"license": "28119850A",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "01044009A",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "02002841A",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "28119850A",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "28150957A",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "01044028B",
"state": "IN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Sycamore Springs",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Lafayette, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.