Individual provider Active NPI

Evarest N Bubonye I

  • Nurse's Aide
  • Cincinnati, OH
National Provider Identifier
1003366857
Registry record updated Oct 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
401365000312 Issued in OH
Practice address
1804 Goodman Ave Apt 4
Cincinnati, OH 45239-4855
Phone
(513) 394-9219
NPI assigned
Oct 5, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X 401365000312 OH Primary

Addresses

Primary practice location

1804 Goodman Ave Apt 4
Cincinnati, OH 45239-4855

Mailing address

1804 Goodman Ave Apt 4
Cincinnati, OH 45239-4855
Phone (513) 394-9219

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
401365000312OHMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1475625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475625600000",
    "number": "1003366857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 GOODMAN AVE APT 4",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452394855",
            "telephone_number": "513-394-9219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1804 GOODMAN AVE APT 4",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452394855",
            "telephone_number": "513-394-9219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUBONYE",
        "first_name": "EVAREST",
        "middle_name": "N",
        "name_prefix": "Mr.",
        "name_suffix": "I",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-05",
        "last_updated": "2016-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "OH",
            "license": "401365000312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2016; 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.