Active NPI
Fatai Adegbenro
- Registered Nurse
- Springfield Gardens, NY
National Provider Identifier
1306269451
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 652477-1
- Practice address
- 14140 182ND St
Springfield Garden
Springfield Gardens, NY 11413-3037 - Phone
- (347) 406-2022
- NPI assigned
- Jan 27, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 652477-1 | NY | Primary |
Addresses
Primary practice location
14140 182ND St
Springfield Garden
Springfield Gardens, NY 11413-3037
Mailing address
14140 182ND St
Springfield Garden
Springfield Gardens, NY 11413-3037
Phone (347) 406-2022
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 |
|---|---|---|---|
| 652477-1 | NY | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1390780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390780800000",
"number": "1306269451",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14140 182ND ST",
"address_2": "SPRINGFIELD GARDEN",
"city": "SPRINGFIELD GARDENS",
"state": "NY",
"postal_code": "114133037",
"telephone_number": "347-406-2022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14140 182ND ST",
"address_2": "SPRINGFIELD GARDEN",
"city": "SPRINGFIELD GARDENS",
"state": "NY",
"postal_code": "114133037",
"telephone_number": "347-406-2022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADEGBENRO",
"first_name": "FATAI",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-01-27",
"last_updated": "2014-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "652477-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield Gardens, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 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.