Individual provider Active NPI

Caroline N Onuegbu, LPN

  • Licensed Practical Nurse
  • Brockton, MA
National Provider Identifier
1053061622
Registry record updated Mar 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LN91766 Issued in MA
Practice address
180 Centre St
Brockton, MA 02302-2733
Phone
(774) 719-9422
NPI assigned
Mar 26, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LN91766 MA Primary

Addresses

Primary practice location

180 Centre St
Brockton, MA 02302-2733

Mailing address

30 Brookdale Rd
Stoughton, MA 02072-3309
Phone (781) 975-2633

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
LN91766MAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1648252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648252800000",
    "number": "1053061622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 BROOKDALE RD",
            "city": "STOUGHTON",
            "state": "MA",
            "postal_code": "020723309",
            "telephone_number": "781-975-2633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 CENTRE ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023022733",
            "telephone_number": "774-719-9422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONUEGBU",
        "first_name": "CAROLINE",
        "middle_name": "N",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-26",
        "last_updated": "2022-03-26",
        "certification_date": "2022-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MA",
            "license": "LN91766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 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.