Individual provider Active NPI

Fanta Kaba, RN

  • Registered Nurse
  • Bronx, NY
National Provider Identifier
1003403866
Registry record updated Dec 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
793757 Issued in NY
Practice address
100 W Kingsbridge Rd
Bronx, NY 10468-3961
Phone
(718) 410-1500
NPI assigned
Dec 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2020

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 793757 NY Primary

Addresses

Primary practice location

100 W Kingsbridge Rd
Bronx, NY 10468-3961

Mailing address

1100 Franklin Ave Apt 3a
Bronx, NY 10456-5575
Phone (646) 377-8166

Other practice location 1

900 Intervale Ave
Bronx, NY 10459-4240
Phone (646) 377-8166

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
793757NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1609113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609113600000",
    "number": "1003403866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 FRANKLIN AVE APT 3A",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104565575",
            "telephone_number": "646-377-8166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W KINGSBRIDGE RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104683961",
            "telephone_number": "718-410-1500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 Intervale Ave",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104594240",
            "country_code": "US",
            "telephone_number": "646-377-8166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KABA",
        "first_name": "FANTA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-28",
        "last_updated": "2020-12-28",
        "certification_date": "2020-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "793757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2020; 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.