Individual provider Active NPI

Stella Ofoma

  • Registered Nurse
  • Bronx, NY
National Provider Identifier
1114400231
Registry record updated Sep 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
717989 Issued in NY
Practice address
3520 Tryon Ave Apt 303
Bronx, NY 10467-1558
Phone
(917) 747-0067
NPI assigned
Sep 14, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 717989 NY Primary

Addresses

Primary practice location

3520 Tryon Ave Apt 303
Bronx, NY 10467-1558

Mailing address

3520 Tryon Ave Apt 303
Bronx, NY 10467-1558

Other practice location 1

3520 Tryon Ave Apt 303
Bronx, NY 10467-1558
Phone (917) 747-0067

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
717989NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1536883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536883200000",
    "number": "1114400231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3520 TRYON AVE APT 303",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104671558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3520 TRYON AVE APT 303",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104671558",
            "telephone_number": "917-747-0067"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3520 Tryon Ave Apt 303",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104671558",
            "country_code": "US",
            "telephone_number": "917-747-0067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OFOMA",
        "first_name": "STELLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-14",
        "last_updated": "2018-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "717989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2018; 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.