Aniekan Nwabuebo, DPT

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

PT296532 Issued in CA

Practice address

301 Industrial Rd
San Carlos, CA 94070-2603

Phone

(650) 632-0816

NPI assigned

May 14, 2007

Last updated

Dec 20, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 6

Addresses

Other names 1

• Aniekan Udofia Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• North Carolina Luna Care Physical Therapy LLC

  • Physical Therapist
  • Hendersonville, NC
  • NPI 1124626148
  NPD

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1336355940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18292 ST GEORGES CT",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201767421",
            "telephone_number": "703-209-3359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 INDUSTRIAL RD",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940702603",
            "telephone_number": "650-632-0816"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4066 Verdin Pl",
            "address_purpose": "LOCATION",
            "city": "Dublin",
            "state": "CA",
            "postal_code": "945687423",
            "country_code": "US",
            "telephone_number": "256-210-9609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NWABUEBO",
        "first_name": "ANIEKAN",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-14",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01220100",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305204026",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "028228-1",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "21470",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "VA",
            "license": "2305204026",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "PT296532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANIEKAN",
            "last_name": "UDOFIA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mary Lee Nickel, L.AC.
• Elizabeth Anne Nielsen, M.A., MFT
• Ninh Huy Tran, M.D., Inc.
• Scott David Nissenbaum, DC
• Ralph Charles Notor, MFT
• Sandra Nyholm Goncalves
• Derek Y. Obayashi, M.D.
• Occupational Health Centers of California, a Medical Corporation (Concentra Medical Center)
• Shoko Odani
• Ellen G Offermann, MD

• Physical Medicine & Rehabilitation Physician in San Carlos, CA
• Providers in San Carlos, CA by specialty
• Physical Medicine & Rehabilitation Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; 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.