Individual provider Active NPI

Jomo Tibby, RN

  • Registered Nurse
  • Bronx, NY
National Provider Identifier
1265678049
Registry record updated Dec 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
593995 Issued in NY
Practice address
4220 Hutchinson River Pkwy E Apt 6D
Bronx, NY 10475-4741
Phone
(646) 261-0832
NPI assigned
Dec 27, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2008

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 593995 NY Primary

Addresses

Primary practice location

4220 Hutchinson River Pkwy E Apt 6D
Bronx, NY 10475-4741

Mailing address

4220 Hutchinson River Pkwy E Apt 6D
Bronx, NY 10475-4741
Phone (646) 261-0832

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
593995NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1230336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1230336000000",
    "number": "1265678049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4220 HUTCHINSON RIVER PKWY E APT 6D",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104754741",
            "telephone_number": "646-261-0832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4220 HUTCHINSON RIVER PKWY E APT 6D",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104754741",
            "telephone_number": "646-261-0832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIBBY",
        "first_name": "JOMO",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-12-27",
        "last_updated": "2008-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "593995",
            "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 27, 2008; 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.