Active NPI
Adowa Serwa Osei Nyarko, RN. CCM
- Administrator Registered Nurse
- Valencia, CA
National Provider Identifier
1245350461
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Administrator Registered Nurse
- License
- 790732
- Practice address
- 24910 Avenue Tibbitts Ste 5
Valencia, CA 91355-3426 - Phone
- (661) 771-6609
- NPI assigned
- Mar 30, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 8
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 790732 | CA | |
| Case Management Registered Nurse | 163WC0400X | 4205479 | CA | |
| Community Health Registered Nurse | 163WC1500X | 790732 | CA | |
| Home Health Registered Nurse | 163WH0200X | 790732 | CA | |
| Hospice Registered Nurse | 163WH1000X | 790732 | CA | |
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | 790732 | CA | |
| Wound Care Registered Nurse | 163WW0000X | 790732 | CA | |
| Administrator Registered Nurse | 163WA2000X | 790732 | CA | Primary |
Addresses
Primary practice location
24910 Avenue Tibbitts Ste 5
Valencia, CA 91355-3426
Mailing address
24910 Avenue Tibbitts
Valencia, CA 91355-3426
Other names 1
- Gifty La Var Davis
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4205479 | CA | MD | Case Management Registered Nurse |
| 790732 | CA | MD | Home Health Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Qu Bit Healthcare Management. LLC | Registered Nurse | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606176000000",
"number": "1245350461",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24910 AVENUE TIBBITTS",
"city": "VALENCIA",
"state": "CA",
"postal_code": "913553426"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24910 AVENUE TIBBITTS STE 5",
"city": "VALENCIA",
"state": "CA",
"postal_code": "913553426",
"telephone_number": "661-771-6609"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OSEI NYARKO",
"first_name": "ADOWA SERWA",
"credential": "RN. CCM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-30",
"last_updated": "2020-11-24",
"certification_date": "2020-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "790732",
"primary": false
},
{
"code": "163WC0400X",
"taxonomy_group": "",
"desc": "Registered Nurse, Case Management",
"state": "CA",
"license": "4205479",
"primary": false
},
{
"code": "163WC1500X",
"taxonomy_group": "",
"desc": "Registered Nurse, Community Health",
"state": "CA",
"license": "790732",
"primary": false
},
{
"code": "163WH0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Home Health",
"state": "CA",
"license": "790732",
"primary": false
},
{
"code": "163WH1000X",
"taxonomy_group": "",
"desc": "Registered Nurse, Hospice",
"state": "CA",
"license": "790732",
"primary": false
},
{
"code": "163WP0808X",
"taxonomy_group": "",
"desc": "Registered Nurse, Psychiatric/Mental Health",
"state": "CA",
"license": "790732",
"primary": false
},
{
"code": "163WW0000X",
"taxonomy_group": "",
"desc": "Registered Nurse, Wound Care",
"state": "CA",
"license": "790732",
"primary": false
},
{
"code": "163WA2000X",
"taxonomy_group": "",
"desc": "Registered Nurse, Administrator",
"state": "CA",
"license": "790732",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "GIFTY",
"last_name": "LA VAR DAVIS",
"credential": "RN. CCM",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Valencia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.