Individual provider Active NPI

Bokamano Nsona

  • Contractor
  • Columbus, OH
National Provider Identifier
1164301867
Registry record updated Aug 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
License
SL126947 Issued in OH
Practice address
1546 Fahlander Dr S
Columbus, OH 43229-5110
Phone
(937) 554-5635
NPI assigned
Aug 28, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X SL126947 OH Primary

Addresses

Primary practice location

1546 Fahlander Dr S
Columbus, OH 43229-5110

Mailing address

1546 Fahlander Dr S
Columbus, OH 43229-5110
Phone (937) 554-5635

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
SL126947OHMDContractor

NPI Registry JSON

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

{
    "created_epoch": "1756339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756339200000",
    "number": "1164301867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1546 FAHLANDER DR S",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432295110",
            "telephone_number": "937-554-5635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1546 FAHLANDER DR S",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432295110",
            "telephone_number": "937-554-5635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NSONA",
        "first_name": "BOKAMANO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-28",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "OH",
            "license": "SL126947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2025; 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.