Individual provider Active NPI

Fatmata Fofana

  • Licensed Practical Nurse
  • Columbus, OH
National Provider Identifier
1174268692
Registry record updated Apr 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
166261 Issued in OH
Practice address
1380 Dublin Rd
Columbus, OH 43215-1025
Phone
(614) 488-7117
NPI assigned
Apr 29, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 166261 OH Primary

Addresses

Primary practice location

1380 Dublin Rd
Columbus, OH 43215-1025

Mailing address

1380 Dublin Rd
Columbus, OH 43215-1025
Phone (614) 488-7117

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
166261OHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1651190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651190400000",
    "number": "1174268692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 DUBLIN RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432151025",
            "telephone_number": "614-488-7117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 DUBLIN RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432151025",
            "telephone_number": "614-488-7117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOFANA",
        "first_name": "FATMATA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-29",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "166261",
            "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 Apr 29, 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.