Individual provider Active NPI

Gilbert Nyakundi Ogamba

  • Case Management Registered Nurse
  • Champlin, MN
National Provider Identifier
1265190722
Registry record updated Dec 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management Registered NurseTaxonomy code 163WC0400X
License
2064714 Issued in MN
Practice address
8357 116TH Way N
Champlin, MN 55316-2725
Phone
(952) 228-1472
NPI assigned
Dec 2, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WC0400X 2064714 MN Primary

Addresses

Primary practice location

8357 116TH Way N
Champlin, MN 55316-2725

Mailing address

9699 Knightsbridge Rd Apt 26
Eden Prairie, MN 55347-4317
Phone (952) 228-1472

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
2064714MNMDCase Management Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1638403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1265190722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9699 KNIGHTSBRIDGE RD APT 26",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553474317",
            "telephone_number": "952-228-1472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8357 116TH WAY N",
            "city": "CHAMPLIN",
            "state": "MN",
            "postal_code": "553162725",
            "telephone_number": "952-228-1472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGAMBA",
        "first_name": "GILBERT",
        "middle_name": "NYAKUNDI",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-12-02",
        "last_updated": "2021-12-02",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Case Management",
            "state": "MN",
            "license": "2064714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Champlin, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2021; 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.