NPIMap

Organization Active NPI

Non-Agency RN

  • Skilled Nursing Facility
  • Columbus, OH
National Provider Identifier
1306863964
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
RN282042 Issued in OH
Legal business name
NON-AGENCY RN
Practice address
4665 E Main St Apt 17
Columbus, OH 43213-3134
Phone
(614) 209-6947
NPI assigned
Jul 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Abu B. Kalokoh
Title
RN
Phone
(614) 209-6947

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X RN282042 OH Primary

Addresses

Primary practice location

4665 E Main St Apt 17
Columbus, OH 43213-3134

Mailing address

4665 E Main St Apt 17
Columbus, OH 43213-3134
Phone (614) 209-6947

Other identifiers 1

IdentifierTypeStateIssuer
2606817MedicaidOH

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306863964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4665 E MAIN ST APT 17",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432133134",
            "telephone_number": "614-209-6947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4665 E MAIN ST APT 17",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432133134",
            "telephone_number": "614-209-6947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NON-AGENCY RN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KALOKOH",
        "authorized_official_first_name": "ABU",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "RN",
        "authorized_official_telephone_number": "614-209-6947"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OH",
            "license": "RN282042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2606817",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.

Verify at the official NPI Registry.