Individual provider Active NPI

Temitope Fawole

  • Registered Nurse
  • Staten Island, NY
National Provider Identifier
1003058447
Registry record updated May 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
597711 Issued in NY
Practice address
185 Saint Marks PL
Staten Island, NY 10301-1670
Phone
(212) 677-7400
NPI assigned
Mar 31, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 597711 NY Primary

Addresses

Primary practice location

185 Saint Marks PL
Staten Island, NY 10301-1670

Mailing address

185 Saint Marks PL
Staten Island, NY 10301-1670

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

State licenses

LicenseStateTypeSpecialty
597711NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1238457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273449600000",
    "number": "1003058447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 SAINT MARKS PL",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103011670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 SAINT MARKS PL",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103011670",
            "telephone_number": "212-677-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAWOLE",
        "first_name": "TEMITOPE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-31",
        "last_updated": "2010-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "597711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2010; 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.