Individual provider Active NPI

Vincent Ezenwa Duru, MS, BCBA

  • Behavior Analyst
  • Terre Haute, IN
National Provider Identifier
1669719712
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-22-59222 Issued in IN
Practice address
399 Hospital LN
Terre Haute, IN 47802-4394
Phone
(812) 645-2308
Fax
(317) 520-8200
NPI assigned
Jan 9, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X
Community Health Worker 172V00000X
Behavior Analyst 103K00000X 1-22-59222 IN Primary

Addresses

Primary practice location

399 Hospital LN
Terre Haute, IN 47802-4394

Mailing address

3500 Depauw Blvd Ste 3070
Indianapolis, IN 46268-6135
Phone (855) 324-0885

Other practice location 1

5350 Machado Ln
Culver City, CA 90230-8800
Phone (310) 737-9393

Other practice location 2

5859 W Talavi Blvd Ste 180
Glendale, AZ 85306-1873
Phone (602) 560-2836

Other identifiers 2

IdentifierTypeStateIssuer
172V00000XOtherCACOMMUNITY HEALTH WORKER
1-22-59222OtherBCBA CERT

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
Credentials
Master of Science

NPI Registry JSON

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

{
    "created_epoch": "1357689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1669719712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 DEPAUW BLVD STE 3070",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462686135",
            "telephone_number": "855-324-0885",
            "fax_number": "317-520-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "399 HOSPITAL LN",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478024394",
            "telephone_number": "812-645-2308",
            "fax_number": "317-520-8200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5350 Machado Ln",
            "address_purpose": "LOCATION",
            "city": "Culver City",
            "state": "CA",
            "postal_code": "902308800",
            "country_code": "US",
            "telephone_number": "310-737-9393",
            "fax_number": "310-881-0069",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5859 W Talavi Blvd Ste 180",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853061873",
            "country_code": "US",
            "telephone_number": "602-560-2836",
            "fax_number": "317-520-8200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DURU",
        "first_name": "VINCENT",
        "middle_name": "EZENWA",
        "credential": "MS, BCBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-09",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IN",
            "license": "1-22-59222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY HEALTH WORKER",
            "identifier": "172V00000X",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBA CERT",
            "identifier": "1-22-59222",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Terre Haute, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.