Individual provider Active NPI

Bassam Nooman, RN

  • Registered Nurse
  • North Olmsted, OH
National Provider Identifier
1336482306
Registry record updated Mar 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
379059 Issued in OH
Practice address
25861 Kennedy Ridge Rd
North Olmsted, OH 44070-4530
Phone
(440) 984-8601
NPI assigned
Mar 28, 2013
Last updated
Mar 28, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2013

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 379059 OH Primary

Addresses

Primary practice location

25861 Kennedy Ridge Rd
North Olmsted, OH 44070-4530

Mailing address

25861 Kennedy Ridge Rd
North Olmsted, OH 44070
Phone (440) 984-8601

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
379059OHMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1364428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364428800000",
    "number": "1336482306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25861 KENNEDY RIDGE RD",
            "city": "NORTH OLMSTED",
            "state": "OH",
            "postal_code": "44070",
            "telephone_number": "440-984-8601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25861 KENNEDY RIDGE RD",
            "city": "NORTH OLMSTED",
            "state": "OH",
            "postal_code": "440704530",
            "telephone_number": "440-984-8601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOOMAN",
        "first_name": "BASSAM",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-28",
        "last_updated": "2013-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "379059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Olmsted, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2013; 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.