Individual provider Active NPI

Lubasi Kamuti Sr., RN, PHN

  • Child & Adolescent Psychiatric/Mental Health Registered Nurse
  • Minneapolis, MN
National Provider Identifier
1093379059
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0807X
License
2471610 Issued in MN
Practice address
726 2ND St NE
Minneapolis, MN 55413-1662
Phone
(763) 230-0737
Fax
(651) 229-5399
NPI assigned
Apr 25, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatric/Mental Health Registered Nurse 163WP0807X 2471610 MN Primary

Addresses

Primary practice location

726 2ND St NE
Minneapolis, MN 55413-1662

Mailing address

726 2ND St NE
Minneapolis, MN 55413-1662
Phone (612) 230-0737

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
2471610MNMDChild & Adolescent Psychiatric/Mental Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1556150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1093379059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "726 2ND ST NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554131662",
            "telephone_number": "612-230-0737",
            "fax_number": "651-229-5399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "726 2ND ST NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554131662",
            "telephone_number": "763-230-0737",
            "fax_number": "651-229-5399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMUTI",
        "first_name": "LUBASI",
        "name_suffix": "Sr.",
        "credential": "RN, PHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-25",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "MN",
            "license": "2471610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.