Individual provider Active NPI

Constance A Oguguo, RN

  • Home Health Registered Nurse
  • Maplewood, NJ
National Provider Identifier
1053147496
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
License
26NO10705800 Issued in NJ
Practice address
1453 Springfield Ave
Maplewood, NJ 07040-2403
Phone
(973) 968-0551
NPI assigned
Sep 11, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Registered Nurse 163WG0600X 26NO10705800 NJ
Medical-Surgical Registered Nurse 163WM0705X 26NO10705800 NJ
Home Health Registered Nurse 163WH0200X 26NO10705800 NJ Primary

Addresses

Primary practice location

1453 Springfield Ave
Maplewood, NJ 07040-2403

Mailing address

1453 Springfield Ave
Maplewood, NJ 07040-2403

Other practice location 1

1453 Springfield Ave
Maplewood, NJ 07040-2403
Phone (973) 968-0551

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
26NO10705800NJMDGerontology Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Liberty Medical Care Services LLC CurrentSince Dec 29, 2024 Accepting new patients

Locations

1453 Springfield Ave
Maplewood, NJ 07040
Phone (973) 761-8900

Organizations & group practices 1

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": "1726012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1053147496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1453 SPRINGFIELD AVE",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070402403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1453 SPRINGFIELD AVE",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070402403",
            "telephone_number": "973-968-0551"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1453 Springfield Ave",
            "address_purpose": "LOCATION",
            "city": "Maplewood",
            "state": "NJ",
            "postal_code": "070402403",
            "country_code": "US",
            "telephone_number": "973-968-0551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OGUGUO",
        "first_name": "CONSTANCE",
        "middle_name": "A",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-11",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gerontology",
            "state": "NJ",
            "license": "26NO10705800",
            "primary": false
        },
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "NJ",
            "license": "26NO10705800",
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "NJ",
            "license": "26NO10705800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.