Individual provider Active NPI

Clare Ime Mbang

  • General Practice Registered Nurse
  • Spokane, WA
National Provider Identifier
1154198018
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
1086771 Issued in TX
Practice address
17 E 8TH Ave
Spokane, WA 99202-1201
Phone
(509) 474-5678
NPI assigned
Dec 11, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 1086771 TX Primary

Addresses

Primary practice location

17 E 8TH Ave
Spokane, WA 99202-1201

Mailing address

5460 Babcock Rd Ste 120
San Antonio, TX 78240-3400
Phone (210) 996-5777

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
1086771TXMDGeneral Practice Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1702252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1154198018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5460 BABCOCK RD STE 120",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782403400",
            "telephone_number": "210-996-5777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 E 8TH AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992021201",
            "telephone_number": "509-474-5678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MBANG",
        "first_name": "CLARE",
        "middle_name": "IME",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-11",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "TX",
            "license": "1086771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

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