Individual provider Active NPI

Sikholisile Nyoni, FNP-BC

  • Family Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1538772306
Registry record updated Sep 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71010352A Issued in IN
Practice address
3815 River Crossing Pkwy Ste 100
Indianapolis, IN 46240-7766
Phone
(844) 753-3314
NPI assigned
Aug 31, 2020
Last updated
Sep 25, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71010352B IN
Family Nurse Practitioner 363LF0000X 71010352A IN Primary

Addresses

Primary practice location

3815 River Crossing Pkwy Ste 100
Indianapolis, IN 46240-7766

Mailing address

3815 River Crossing Pkwy Ste 100
Indianapolis, IN 46240-7766
Phone (844) 753-3314

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
I20201006001471 IN Practitioner - Nurse Practitioner 5698194942 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Group practices
Great Lakes Behavior Management Specialists, Inc.Group PAC ID 9436580958, 9 clinicians

Practice addresses (Care Compare)

6910 N Main St
Unit 52
Granger, IN 46530-8412
Phone (574) 231-6766

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
71010352BINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Great Lakes Behavior Management Specialists, Inc. CurrentSince Sep 17, 2024 Accepting new patients

Locations

6910 N Main St
Unit 52
Granger, IN 46530
Phone (574) 231-6766

Interoperability endpoints

  • Direct secure messaging: snyoni20845@carelonhealth.direct-ci.com

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": "1598832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600992000000",
    "number": "1538772306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3815 RIVER CROSSING PKWY STE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462407766",
            "telephone_number": "844-753-3314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3815 RIVER CROSSING PKWY STE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462407766",
            "telephone_number": "844-753-3314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYONI",
        "first_name": "SIKHOLISILE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-31",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71010352B",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71010352A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.