Individual provider Active NPI

Gberrah Roy Idriss, RN

  • Psychiatric/Mental Health Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1770433617
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN.CNP.0041946 Issued in OH
Practice address
465 Harmon Ave
Columbus, OH 43223-2405
Phone
(614) 222-3737
Fax
(614) 358-4201
NPI assigned
Jan 30, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN.470931 OH
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN.CNP.0041946 OH Primary

Addresses

Primary practice location

465 Harmon Ave
Columbus, OH 43223-2405

Mailing address

11361 N 99TH Ave Ste 402
Peoria, AZ 85345-5459
Phone (602) 650-1212

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN.470931OHMDRegistered Nurse
APRN.CNP.0041946OHMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1769731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776211200000",
    "number": "1770433617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11361 N 99TH AVE STE 402",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853455459",
            "telephone_number": "602-650-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 HARMON AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432232405",
            "telephone_number": "614-222-3737",
            "fax_number": "614-358-4201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IDRISS",
        "first_name": "GBERRAH",
        "middle_name": "ROY",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-01-30",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.470931",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0041946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2026; 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.