Individual provider Active NPI

James F Nabwangu, MD

  • Neurological Surgery Physician
  • Rapid City, SD
National Provider Identifier
1083700512
Registry record updated Nov 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
4934 Issued in SD
Practice address
2805 5TH St
Suite 100
Rapid City, SD 57701-6003
Phone
(605) 719-5650
Fax
(605) 719-5655
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 4934 SD Primary

Addresses

Primary practice location

2805 5TH St
Suite 100
Rapid City, SD 57701-6003

Mailing address

PO Box 3450
Rapid City, SD 57709-3450
Phone (605) 719-5650

Other identifiers 1

IdentifierTypeStateIssuer
6100783MedicaidSD

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4934SDMDNeurological Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194048000000",
    "number": "1083700512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3450",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577093450",
            "telephone_number": "605-719-5650",
            "fax_number": "605-719-5655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2805 5TH ST",
            "address_2": "SUITE 100",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577016003",
            "telephone_number": "605-719-5650",
            "fax_number": "605-719-5655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NABWANGU",
        "first_name": "JAMES",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "SD",
            "license": "4934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6100783",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2007; 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.