Individual provider Active NPI

Kyle Robert Thomas, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Lafayette, IN
National Provider Identifier
1992584270
Registry record updated Jan 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
28240808A Issued in IN
Practice address
833 Park East Blvd
Lafayette, IN 47905-0785
Phone
(765) 743-4400
NPI assigned
Sep 26, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 28240808A IN Primary
Registered Nurse 163W00000X 28240808A IN
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 71015433A IN

Addresses

Primary practice location

833 Park East Blvd
Lafayette, IN 47905-0785

Mailing address

833 Park East Blvd
Lafayette, IN 47905-0785
Phone (765) 743-4400

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
I20240823000479 IN Practitioner - Nurse Practitioner 2860931789 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sycamore Springs Physician Group LLCGroup PAC ID 2062634991, 11 clinicians

Practice addresses (Care Compare)

833 Park E Blvd
Lafayette, IN 47905-0785
Phone (765) 743-4400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28240808AINMDPsychiatric/Mental Health Nurse Practitioner
71015433AINMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Acute Behavioral Health Services, P.C. CurrentSince Jul 29, 2024 Accepting new patients
Sycamore Springs Physician Group LLC CurrentSince Aug 1, 2025 Accepting new patients

Locations

3733 Rome Dr
Lafayette, IN 47905
Phone (765) 446-9394

833 Park East Blvd
Lafayette, IN 47905
Phone (765) 441-3168

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1695686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736640000000",
    "number": "1992584270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 PARK EAST BLVD",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479050785",
            "telephone_number": "765-743-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 PARK EAST BLVD",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479050785",
            "telephone_number": "765-743-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "KYLE",
        "middle_name": "ROBERT",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-26",
        "last_updated": "2025-01-12",
        "certification_date": "2025-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "28240808A",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28240808A",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "71015433A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

Verify at the official NPI Registry.