Individual provider Active NPI

Beryl Chiboyiwa

  • Psychiatric/Mental Health Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1427745926
Registry record updated Apr 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
71013835A Issued in IN
Practice address
6720 Parkdale PL
Indianapolis, IN 46254-4668
Phone
(317) 744-9200
NPI assigned
Apr 24, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 71013835A IN Primary

Addresses

Primary practice location

6720 Parkdale PL
Indianapolis, IN 46254-4668

Mailing address

6746 Sundown Dr S
Indianapolis, IN 46254-3660
Phone (317) 657-4569

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230622000268 IN Practitioner - Nurse Practitioner 6800254996 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aims, LLC CurrentSince May 20, 2023 Accepting new patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Feb 3, 2026 Accepting new patients

Locations

417 S Whitlock St
Bremen, IN 46506
Phone (574) 546-0330

6720 Parkdale Pl
Indianapolis, IN 46254
Phone (219) 648-2400

1625 E Jefferson Blvd
Mishawaka, IN 46545
Phone (219) 257-2295

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1682294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1427745926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6746 SUNDOWN DR S",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462543660",
            "telephone_number": "317-657-4569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6720 PARKDALE PL",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462544668",
            "telephone_number": "317-744-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIBOYIWA",
        "first_name": "BERYL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-24",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "71013835A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.