Individual provider Active NPI

Moses Thuku

  • Medical-Surgical Registered Nurse
  • Elk Grove, CA
National Provider Identifier
1205668563
Registry record updated Sep 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical-Surgical Registered NurseTaxonomy code 163WM0705X
License
95375209 Issued in CA
Practice address
7673 Chappelle Way
Elk Grove, CA 95757-1688
Phone
(443) 710-3011
NPI assigned
Aug 15, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Administrator Registered Nurse 163WA2000X R203682 MD
General Practice Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WG0000X 95375209 CA
Home Health Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WH0200X R203682 MD
Medical-Surgical Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WM0705X 95375209 CA Primary

Addresses

Primary practice location

7673 Chappelle Way
Elk Grove, CA 95757-1688

Mailing address

7673 Chappelle Way
Elk Grove, CA 95757-1688

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
R203682MDMDHome Health Registered Nurse
95375209CAMDMedical-Surgical Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1723680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1205668563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7673 CHAPPELLE WAY",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957571688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7673 CHAPPELLE WAY",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957571688",
            "telephone_number": "443-710-3011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THUKU",
        "first_name": "MOSES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-08-15",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "MD",
            "license": "R203682",
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, General Practice",
            "state": "CA",
            "license": "95375209",
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Home Health",
            "state": "MD",
            "license": "R203682",
            "primary": false
        },
        {
            "code": "163WM0705X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "CA",
            "license": "95375209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2024; 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.