Individual provider Active NPI

Kenny Chrysostome

  • Psychiatric/Mental Health Nurse Practitioner
  • Kansas City, KS
National Provider Identifier
1407569817
Registry record updated Aug 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
5385388081 Issued in KS
Practice address
8929 Parallel Pkwy
Kansas City, KS 66112-1689
Phone
(913) 596-4000
NPI assigned
Dec 30, 2022
Last updated
Aug 11, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2026

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

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X SP035653 PA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NP004147 GA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X CNP251894 ME
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5385388081 KS Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 71017854A IN
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11042205 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0041464 OH
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2026018306 MO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209035574 IL

Addresses

Primary practice location

8929 Parallel Pkwy
Kansas City, KS 66112-1689

Mailing address

115 Jay CT
Royal Palm Beach, FL 33411-1723
Phone (561) 797-9787

Other practice location 1

4810 Riverstone Blvd Ste 100
Missouri City, TX 77459-4092
Phone (877) 744-6483

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME, OH, IN, KS4 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20260223002565 ME Practitioner - Nurse Practitioner 2668953134 Reassigns benefits to 1 organization
I20260225000949 OH Practitioner - Nurse Practitioner 2668953134 Reassigns benefits to 1 organization
I20260320000545 IN Practitioner - Nurse Practitioner 2668953134 Reassigns benefits to 1 organization
I20260407001613 KS Practitioner - Nurse Practitioner 2668953134 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

115 Jay CT
Royal Palm Beach, FL 33411-1723

4810 Riverstone Blvd
Suite 100
Missouri City, TX 77459-4092

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN11042205FLMDPsychiatric/Mental Health Nurse Practitioner
NP004147GAMDPsychiatric/Mental Health Nurse Practitioner
209035574ILMDPsychiatric/Mental Health Nurse Practitioner
71017854AINMDPsychiatric/Mental Health Nurse Practitioner
5385388081KSMDPsychiatric/Mental Health Nurse Practitioner
CNP251894MEMDPsychiatric/Mental Health Nurse Practitioner
2026018306MOMDPsychiatric/Mental Health Nurse Practitioner
0041464OHMDPsychiatric/Mental Health Nurse Practitioner
SP035653PAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
TP Health TX PC CurrentSince Jan 12, 2026 Accepting new patients
TP-Health Incorporated CurrentSince Jan 18, 2026 Accepting new patients

Locations

4011 S Monroe Medical Park Blvd
Bloomington, IN 47403
Phone (812) 825-5777

8929 Parallel Pkwy
Kansas City, KS 66112
Phone (913) 596-3930

770 Roosevelt Trl
Ste 8
North Windham, ME 04062
Phone (207) 300-2471

1000 Carondelet Dr
Kansas City, MO 64114
Phone (816) 942-4400

1460 Orange St
Coshocton, OH 43812
Phone (740) 545-7919

4810 Riverstone Blvd
Ste 100
Missouri City, TX 77459
Phone (832) 916-2677

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1672358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786406400000",
    "number": "1407569817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 JAY CT",
            "city": "ROYAL PALM BEACH",
            "state": "FL",
            "postal_code": "334111723",
            "telephone_number": "561-797-9787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8929 PARALLEL PKWY",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661121689",
            "telephone_number": "913-596-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4810 Riverstone Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Missouri City",
            "state": "TX",
            "postal_code": "774594092",
            "country_code": "US",
            "telephone_number": "877-744-6483",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHRYSOSTOME",
        "first_name": "KENNY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-30",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP035653",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "NP004147",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ME",
            "license": "CNP251894",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KS",
            "license": "5385388081",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "71017854A",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11042205",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "0041464",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2026018306",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209035574",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, KS

Sources for this page

Verify at the official NPI Registry.