Individual provider Active NPI

Bukola Owolabi, RN

  • Registered Nurse
  • Far Rockaway, NY
National Provider Identifier
1164826780
Registry record updated Oct 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
691822 Issued in NY
Practice address
312 Beach 48TH St
Far Rockaway
Far Rockaway, NY 11691-1121
Phone
(240) 565-5093
NPI assigned
Oct 9, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2014

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 691822 NY Primary

Addresses

Primary practice location

312 Beach 48TH St
Far Rockaway
Far Rockaway, NY 11691-1121

Mailing address

312 Beach 48TH St
Far Rockaway
Far Rockaway, NY 11691-1121
Phone (240) 565-5093

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
691822NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1412812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412812800000",
    "number": "1164826780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 BEACH 48TH ST",
            "address_2": "FAR ROCKAWAY",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116911121",
            "telephone_number": "240-565-5093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 BEACH 48TH ST",
            "address_2": "FAR ROCKAWAY",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116911121",
            "telephone_number": "240-565-5093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWOLABI",
        "first_name": "BUKOLA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-09",
        "last_updated": "2014-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "691822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Far Rockaway, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2014; 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.