Individual provider Active NPI

Oluwafemi Kamil Ekungba

  • Licensed Practical Nurse
  • Eugene, OR
National Provider Identifier
1316382674
Registry record updated Apr 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
201330178LPN Issued in OR
Practice address
2437 Portland Aly
Eugene, OR 97405
Phone
(541) 937-5507
NPI assigned
Apr 30, 2013
Last updated
Apr 23, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 201330178LPN OR Primary

Addresses

Primary practice location

2437 Portland Aly
Eugene, OR 97405

Mailing address

2437 Portland Aly
Eugene, OR 97405
Phone (541) 937-5507

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
201330178LPNORMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1367280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398211200000",
    "number": "1316382674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2437 PORTLAND ALY",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "97405",
            "telephone_number": "541-937-5507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2437 PORTLAND ALY",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "97405",
            "telephone_number": "541-937-5507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKUNGBA",
        "first_name": "OLUWAFEMI",
        "middle_name": "KAMIL",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-30",
        "last_updated": "2014-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OR",
            "license": "201330178LPN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 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.

Verify at the official NPI Registry.