Individual provider Active NPI

Justin Kameni Nana

  • Pharmacist
  • Oklahoma City, OK
National Provider Identifier
1104604651
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
20231 Issued in OK
Practice address
5025 N May Ave
Oklahoma City, OK 73112-6042
Phone
(405) 947-6743
NPI assigned
Sep 18, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 20231 OK Primary

Addresses

Primary practice location

5025 N May Ave
Oklahoma City, OK 73112-6042

Mailing address

10212 Biscay CT
Oklahoma City, OK 73159-6020
Phone (405) 934-8684

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
20231OKMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma CVS Pharmacy LLC PastSince Sep 24, 2023 Accepting new patients
Oklahoma CVS Pharmacy LLC PastSince Sep 24, 2023 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": "1694995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1104604651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10212 BISCAY CT",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731596020",
            "telephone_number": "405-934-8684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5025 N MAY AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731126042",
            "telephone_number": "405-947-6743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANA",
        "first_name": "JUSTIN",
        "middle_name": "KAMENI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-18",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OK",
            "license": "20231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; 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.