Individual provider Active NPI

Dora Valenrine Obiaka-Tierney

  • Registered Nurse
  • Phillipsburg, NJ
National Provider Identifier
1003536947
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
806835 Issued in NY
Practice address
391 Thomas St
Phillipsburg, NJ 08865-3346
Phone
(862) 336-0077
NPI assigned
Aug 31, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2024

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 806835 NY Primary

Addresses

Primary practice location

391 Thomas St
Phillipsburg, NJ 08865-3346

Mailing address

391 Thomas St
Phillipsburg, NJ 08865-3346

Other identifiers 1

IdentifierTypeStateIssuer
806835MedicaidNY

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
806835NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1661904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1003536947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "391 THOMAS ST",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "088653346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 THOMAS ST",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "088653346",
            "telephone_number": "862-336-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBIAKA-TIERNEY",
        "first_name": "DORA",
        "middle_name": "VALENRINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-31",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "806835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806835",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phillipsburg, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2024; 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.