Individual provider Active NPI

Naomi Anyonah Nyabuto

  • Psychiatric/Mental Health Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1871234351
Registry record updated Apr 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1071079 Issued in TX
Practice address
1420 W Mockingbird LN
Dallas, TX 75247-4931
Phone
(469) 983-1300
Fax
(888) 234-7101
NPI assigned
Apr 6, 2022
Last updated
Apr 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2022

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 1071079 TX Primary

Addresses

Primary practice location

1420 W Mockingbird LN
Dallas, TX 75247-4931

Mailing address

8124 Wildwood CT
North Richland Hills, TX 76182-3100
Phone (469) 983-1300

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL https://www.symbiosintegrativehealth.com/
CONNECT URL https://www.symbiosintegrativehealth.com/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240522003174 TX Practitioner - Nurse Practitioner 9638511660 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4500 Mercantile Plaza Dr
Suite 300
Fort Worth, TX 76137-4206
Phone (469) 688-9501

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1071079TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Serene Behavioral Integrative Health LLC Psychiatric/Mental Health CurrentSince May 9, 2024 Accepting new patients
Mental Health Specialty Group PA CurrentSince May 1, 2025 Accepting new patients
Balance Beacon Past Accepting new patients

Locations

600 Congress Ave
Austin, TX 78701
Phone (281) 330-3059

4500 Mercantile Plaza Dr
Ste 300
Ft Worth, TX 76137
Phone (469) 688-9501

Organizations & group practices 3

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": "1649203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1871234351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8124 WILDWOOD CT",
            "city": "NORTH RICHLAND HILLS",
            "state": "TX",
            "postal_code": "761823100",
            "telephone_number": "469-983-1300",
            "fax_number": "888-234-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 W MOCKINGBIRD LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752474931",
            "telephone_number": "469-983-1300",
            "fax_number": "888-234-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYABUTO",
        "first_name": "NAOMI",
        "middle_name": "ANYONAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-06",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1071079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.symbiosintegrativehealth.com/",
            "affiliation": "N",
            "address_1": "1420 W Mockingbird Ln",
            "city": "Dallas",
            "state": "TX",
            "country_code": "US",
            "postal_code": "752474931",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.symbiosintegrativehealth.com/",
            "affiliation": "N",
            "endpointDescription": "CLINIC",
            "address_1": "1420 W Mockingbird Ln",
            "city": "Dallas",
            "state": "TX",
            "country_code": "US",
            "postal_code": "752474931",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.