Individual provider Active NPI

Chiquita Channay O'Bannon

  • Psychiatric/Mental Health Nurse Practitioner
  • West Lafayette, IN
National Provider Identifier
1760340087
Registry record updated Jan 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
209034315 Issued in IL
Practice address
2550 Northwestern Ave # 1100
West Lafayette, IN 47906-1332
Phone
(866) 522-7747
NPI assigned
Jan 14, 2026
Last updated
Jan 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2026

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 209034315 IL Primary

Addresses

Primary practice location

2550 Northwestern Ave # 1100
West Lafayette, IN 47906-1332

Mailing address

2550 Northwestern Ave # 1100
West Lafayette, IN 47906-1332

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20260516000540 IN Practitioner - Nurse Practitioner 4385113547 Reassigns benefits to 2 organizations
I20260519003506 IL Practitioner - Nurse Practitioner 4385113547 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

7877 Willow Chase Blvd
Houston, TX 77070-5934

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209034315ILMDPsychiatric/Mental Health Nurse Practitioner

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": "1768348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768348800000",
    "number": "1760340087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 NORTHWESTERN AVE # 1100",
            "city": "WEST LAFAYETTE",
            "state": "IN",
            "postal_code": "479061332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 NORTHWESTERN AVE # 1100",
            "city": "WEST LAFAYETTE",
            "state": "IN",
            "postal_code": "479061332",
            "telephone_number": "866-522-7747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BANNON",
        "first_name": "CHIQUITA",
        "middle_name": "CHANNAY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-01-14",
        "last_updated": "2026-01-14",
        "certification_date": "2026-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209034315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Lafayette, IN

Sources for this page

Verify at the official NPI Registry.