Individual provider Active NPI

Oumou Wague

  • Social Worker
  • Bronx, NY
National Provider Identifier
1154052710
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
116288-01 Issued in NY
Practice address
845 E 215TH St
Bronx, NY 10467-5812
Phone
(773) 808-1123
NPI assigned
Jun 23, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 116288-01 NY Primary

Addresses

Primary practice location

845 E 215TH St
Bronx, NY 10467-5812

Mailing address

845 E 215TH St
Bronx, NY 10467-5812
Phone (773) 808-1123

Other identifiers 1

IdentifierTypeStateIssuer
00000000MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL oumouwague852GMAIL.COM Health Information Exchange (HIE)

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
116288-01NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1655942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1154052710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "845 E 215TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104675812",
            "telephone_number": "773-808-1123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 E 215TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104675812",
            "telephone_number": "773-808-1123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGUE",
        "first_name": "OUMOU",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-23",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "116288-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00000000",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "oumouwague852GMAIL.COM",
            "affiliation": "N",
            "endpointDescription": "Business email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "845 E 215th St",
            "city": "Bronx",
            "state": "NY",
            "country_code": "US",
            "postal_code": "104675812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Jun 23, 2022; 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.