Individual provider Active NPI

Chika Roseline Ebinum, RN

  • Registered Nurse
  • Bronx, NY
National Provider Identifier
1215206602
Registry record updated Dec 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
548491-1 Issued in NY
Practice address
1125 Wyatt St
Apt. 2E
Bronx, NY 10460-4531
Phone
(347) 621-1147
NPI assigned
Dec 14, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2011

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 548491-1 NY Primary

Addresses

Primary practice location

1125 Wyatt St
Apt. 2E
Bronx, NY 10460-4531

Mailing address

1125 Wyatt St
Apt. 2E
Bronx, NY 10460-4531
Phone (347) 621-1147

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
548491-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1323820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323820800000",
    "number": "1215206602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 WYATT ST",
            "address_2": "APT. 2E",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104604531",
            "telephone_number": "347-621-1147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 WYATT ST",
            "address_2": "APT. 2E",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104604531",
            "telephone_number": "347-621-1147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBINUM",
        "first_name": "CHIKA",
        "middle_name": "ROSELINE",
        "name_prefix": "Miss",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-14",
        "last_updated": "2011-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "548491-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2011; 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.