Individual provider Active NPI

Deyon Brumby, LSW

  • Clinical Social Worker
  • Indianapolis, IN
National Provider Identifier
1265052278
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34010664A Issued in IN
Practice address
5470 E 16TH St
Indianapolis, IN 46218-4861
Phone
(317) 355-5394
NPI assigned
Apr 20, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 33009813A IN
Counselor 101Y00000X
Clinical Social Worker 1041C0700X 34010664A IN Primary

Addresses

Primary practice location

5470 E 16TH St
Indianapolis, IN 46218-4861

Mailing address

5470 E 16TH St
Indianapolis, IN 46218-4861
Phone (317) 355-5394

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231104000566 IN Practitioner - Clinical Social Worker 5496102972 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Health Network IncGroup PAC ID 1850203977, 95 clinicians

Practice addresses (Care Compare)

5470 E 16TH St
Gallahue Mental Health Services
Indianapolis, IN 46218-4861
Phone (317) 355-5394

Merit-based Incentive Payment System (MIPS)

Final score
99.82 of 100Reported as group
Quality
96.14
Promoting interoperability
100
Improvement activities
40
Cost
82.22

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33009813AINMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Network, Inc CurrentSince Oct 1, 2023 Accepting new patients
Community Health Network, Inc Current Accepting new patients
Community Health Network, Inc. Past Accepting new patients

Locations

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

6950 Hillsdale Ct
Indianapolis, IN 46250
Phone (317) 621-7533

5470 E 16th St
Indianapolis, IN 46218
Phone (317) 355-5009

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": "1587340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1265052278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5470 E 16TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462184861",
            "telephone_number": "317-355-5394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5470 E 16TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462184861",
            "telephone_number": "317-355-5394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUMBY",
        "first_name": "DEYON",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-20",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "33009813A",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34010664A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.