Individual provider Active NPI

Agnes Yeboah

  • Registered Nurse
  • Bronx, NY
National Provider Identifier
1043450638
Registry record updated Feb 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
607355 Issued in NY
Practice address
80 McClellan St
Apt 4-P
Bronx, NY 10452-8641
Phone
(646) 327-1618
NPI assigned
Feb 23, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2009

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 607355 NY Primary

Addresses

Primary practice location

80 McClellan St
Apt 4-P
Bronx, NY 10452-8641

Mailing address

80 McClellan St
Apt 4-P
Bronx, NY 10452-8641
Phone (646) 327-1618

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
607355NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1235347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235347200000",
    "number": "1043450638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 MCCLELLAN ST",
            "address_2": "APT 4-P",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104528641",
            "telephone_number": "646-327-1618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 MCCLELLAN ST",
            "address_2": "APT 4-P",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104528641",
            "telephone_number": "646-327-1618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEBOAH",
        "first_name": "AGNES",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-23",
        "last_updated": "2009-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "607355",
            "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 Feb 23, 2009; 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.