Individual provider Active NPI

Louis Martial Boua Anwobor, REGISTERED NURSE

  • Registered Nurse
  • Pittsfield, MA
National Provider Identifier
1326764234
Registry record updated Oct 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN2353602 Issued in MA
Practice address
174 Woodlawn Ave FL 2
Pittsfield, MA 01201-4315
Phone
(413) 281-3898
NPI assigned
Oct 13, 2022
Last updated
Oct 13, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2022

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 RN2353602 MA Primary

Addresses

Primary practice location

174 Woodlawn Ave FL 2
Pittsfield, MA 01201-4315

Mailing address

174 Woodlawn Ave FL 2
Pittsfield, MA 01201-4315
Phone (413) 281-3898

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
RN2353602MAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Saint-Pierre Home Health Care CurrentSince Nov 27, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1665619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1326764234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 WOODLAWN AVE FL 2",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012014315",
            "telephone_number": "413-281-3898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 WOODLAWN AVE FL 2",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012014315",
            "telephone_number": "413-281-3898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANWOBOR",
        "first_name": "LOUIS MARTIAL",
        "middle_name": "BOUA",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-10-13",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2353602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2022; 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.