Individual provider Active NPI

Ayele Bamgbose

  • Adult Companion
  • Lincoln, NE
National Provider Identifier
1366248114
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult CompanionTaxonomy code 372600000X
Practice address
3883 Normal Blvd Ste 206
Lincoln, NE 68506-5218
Phone
(402) 488-4421
Fax
(402) 904-4124
NPI assigned
Feb 21, 2025
Last updated
Feb 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chore Provider 372500000X NU
Adult Companion 372600000X NU Primary
Personal Care Attendant 3747P1801X NU

Addresses

Primary practice location

3883 Normal Blvd Ste 206
Lincoln, NE 68506-5218

Mailing address

1201 S 49TH St
Lincoln, NE 68510-4902
Phone (402) 805-0020

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

Practice roles

OrganizationSpecialtyStatusNew patients
Raouf LLC PastSince Feb 23, 2025 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": "1740096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1366248114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 S 49TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685104902",
            "telephone_number": "402-805-0020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3883 NORMAL BLVD STE 206",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685065218",
            "telephone_number": "402-488-4421",
            "fax_number": "402-904-4124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAMGBOSE",
        "first_name": "AYELE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-21",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "372500000X",
            "taxonomy_group": "",
            "desc": "Chore Provider",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2025; 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.