Individual provider Active NPI

Jumoke Agunbiade

  • Registered Nurse
  • Chester, PA
National Provider Identifier
1003286527
Registry record updated Sep 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
698532 Issued in NY
Practice address
1301 Renshaw Rd
Apt C1
Chester, PA 19013-1575
Phone
(347) 639-5003
NPI assigned
Sep 26, 2015
Last updated
Sep 26, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2015

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 698532 NY Primary
Registered Nurse 163W00000X 669854 PA

Addresses

Primary practice location

1301 Renshaw Rd
Apt C1
Chester, PA 19013-1575

Mailing address

1301 Renshaw Rd
Apt C1
Chester, PA 19013-1575
Phone (347) 639-5003

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
698532NYMDRegistered Nurse
669854PAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1443225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443225600000",
    "number": "1003286527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 RENSHAW RD",
            "address_2": "APT C1",
            "city": "CHESTER",
            "state": "PA",
            "postal_code": "190131575",
            "telephone_number": "347-639-5003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 RENSHAW RD",
            "address_2": "APT C1",
            "city": "CHESTER",
            "state": "PA",
            "postal_code": "190131575",
            "telephone_number": "347-639-5003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUNBIADE",
        "first_name": "JUMOKE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-26",
        "last_updated": "2015-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "698532",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "669854",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chester, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2015; 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.