Individual provider Active NPI

Sylvester O Iyamah, PMHNP - BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Mansfield, TX
National Provider Identifier
1497567614
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1170639 Issued in TX
Practice address
4817 Comstock Way
Mansfield, TX 76063-1985
Phone
(817) 696-1803
NPI assigned
Jan 24, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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 1170639 TX Primary

Addresses

Primary practice location

4817 Comstock Way
Mansfield, TX 76063-1985

Mailing address

4817 Comstock Way
Mansfield, TX 76063-1985
Phone (817) 696-1803

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
1170639TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Splendor Care Health Services Inc Current Accepting new patients

Organizations & group practices 1

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": "1737676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1497567614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4817 COMSTOCK WAY",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760631985",
            "telephone_number": "817-696-1803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4817 COMSTOCK WAY",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760631985",
            "telephone_number": "817-696-1803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IYAMAH",
        "first_name": "SYLVESTER",
        "middle_name": "O",
        "credential": "PMHNP - BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-01-24",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1170639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 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.