Individual provider Active NPI

Manga Fombuh Tita

  • Administrator Registered Nurse
  • Liberty Township, OH
National Provider Identifier
1043740459
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Administrator Registered NurseTaxonomy code 163WA2000X
License
355688 Issued in OH
Practice address
8194 Colyn CT
Liberty Township, OH 45044-8752
Phone
(513) 237-0119
NPI assigned
Jun 18, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 355688 OH
Gerontology Registered Nurse 163WG0600X 355688 OH
Home Health Registered Nurse 163WH0200X 355688 OH
Administrator Registered Nurse 163WA2000X 355688 OH Primary

Addresses

Primary practice location

8194 Colyn CT
Liberty Township, OH 45044-8752

Mailing address

8194 Colyn CT
Liberty Township, OH 45044-8752
Phone (513) 237-0119

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
355688OHMDAdministrator Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Touch Homes Inc Current Accepting new patients
Healing Touch Home Care LLC Current Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1497744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1043740459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8194 COLYN CT",
            "city": "LIBERTY TOWNSHIP",
            "state": "OH",
            "postal_code": "450448752",
            "telephone_number": "513-237-0119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8194 COLYN CT",
            "city": "LIBERTY TOWNSHIP",
            "state": "OH",
            "postal_code": "450448752",
            "telephone_number": "513-237-0119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TITA",
        "first_name": "MANGA",
        "middle_name": "FOMBUH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-18",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "355688",
            "primary": false
        },
        {
            "code": "163WG0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gerontology",
            "state": "OH",
            "license": "355688",
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "OH",
            "license": "355688",
            "primary": false
        },
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "OH",
            "license": "355688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty Township, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.