Individual provider Active NPI

Ernest Boadu Kankam

  • Registered Nurse
  • Bronx, NY
National Provider Identifier
1003557976
Registry record updated Apr 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
761422 Issued in NY
Practice address
1983 Sedgwick Ave Apt GD
Bronx, NY 10453-2717
Phone
(347) 340-9327
NPI assigned
Apr 5, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2022

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 761422 NY Primary

Addresses

Primary practice location

1983 Sedgwick Ave Apt GD
Bronx, NY 10453-2717

Mailing address

1983 Sedgwick Ave Apt GD
Bronx, NY 10453-2717
Phone (347) 340-9327

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
761422NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1003557976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1983 SEDGWICK AVE APT GD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104532717",
            "telephone_number": "347-340-9327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1983 SEDGWICK AVE APT GD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104532717",
            "telephone_number": "347-340-9327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANKAM",
        "first_name": "ERNEST",
        "middle_name": "BOADU",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-05",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "761422",
            "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 Apr 5, 2022; 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.