Active NPI
Elisee Ndenga
- Case Manager/Care Coordinator
- Blacklick, OH
National Provider Identifier
1295134666
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 442 Stone Shadow Dr
Blacklick, OH 43004 - Phone
- (614) 218-5743
- NPI assigned
- Aug 21, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Primary | ||
| Vehicle Modifications Contractor | 171WV0202X |
Addresses
Primary practice location
442 Stone Shadow Dr
Blacklick, OH 43004
Mailing address
442 Stone Shadow Dr
Blacklick, OH 43004-8097
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408579200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1408579200000",
"number": "1295134666",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "442 STONE SHADOW DR",
"city": "BLACKLICK",
"state": "OH",
"postal_code": "430048097"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "442 STONE SHADOW DR",
"city": "BLACKLICK",
"state": "OH",
"postal_code": "43004",
"telephone_number": "614-218-5743"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NDENGA",
"first_name": "ELISEE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-08-21",
"last_updated": "2014-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
},
{
"code": "171WV0202X",
"taxonomy_group": "",
"desc": "Contractor, Vehicle Modifications",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Blacklick, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.