Individual provider Active NPI

John Maina Nyagah, RN

  • Administrator Registered Nurse
  • Sacramento, CA
National Provider Identifier
1336843614
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Administrator Registered NurseTaxonomy code 163WA2000X
License
722685 Issued in CA
Practice address
14 Long Warf PL
Sacramento, CA 95835-2615
Phone
(302) 563-6900
NPI assigned
Mar 29, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Administrator Registered Nurse 163WA2000X 722685 CA Primary

Addresses

Primary practice location

14 Long Warf PL
Sacramento, CA 95835-2615

Mailing address

14 Long Warf PL
Sacramento, CA 95835-2615
Phone (302) 563-6900

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
722685CAMDAdministrator Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1680048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1336843614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 LONG WARF PL",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958352615",
            "telephone_number": "302-563-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 LONG WARF PL",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958352615",
            "telephone_number": "302-563-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYAGAH",
        "first_name": "JOHN",
        "middle_name": "MAINA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-29",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "CA",
            "license": "722685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 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.