Individual provider Active NPI

Yetunde Ajibola Bisayo

  • Behavior Technician
  • Indianapolis, IN
National Provider Identifier
1235936634
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-24-368867 Issued in IN
Practice address
6067 Decatur Blvd
Indianapolis, IN 46241-9606
Phone
(317) 856-5201
NPI assigned
Feb 25, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-24-368867 IN Primary

Addresses

Primary practice location

6067 Decatur Blvd
Indianapolis, IN 46241-9606

Mailing address

6067 Decatur Blvd
Indianapolis, IN 46241-9606
Phone (317) 856-5201

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

LicenseStateTypeSpecialty
RBT-24-368867INMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1740441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1235936634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6067 DECATUR BLVD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462419606",
            "telephone_number": "317-856-5201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6067 DECATUR BLVD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462419606",
            "telephone_number": "317-856-5201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISAYO",
        "first_name": "YETUNDE",
        "middle_name": "AJIBOLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-25",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "IN",
            "license": "RBT-24-368867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2025; 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.