Individual provider Active NPI

Kapili Dauda Manyama, R.N.

  • Registered Nurse
  • Sacramento, CA
National Provider Identifier
1366705964
Registry record updated Jun 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
761809 Issued in CA
Practice address
2341 Northrop Ave Apt 203D
Sacramento, CA 95825-7578
Phone
(832) 512-5377
NPI assigned
Jun 19, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 761809 CA Primary
Registered Nurse 163W00000X 720688 TX

Addresses

Primary practice location

2341 Northrop Ave Apt 203D
Sacramento, CA 95825-7578

Mailing address

2341 Northrop Ave Apt 203D
Sacramento, CA 95825-7578
Phone (832) 512-5377

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
761809CAMDRegistered Nurse
720688TXMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340064000000",
    "number": "1366705964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2341 NORTHROP AVE APT 203D",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958257578",
            "telephone_number": "832-512-5377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2341 NORTHROP AVE APT 203D",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958257578",
            "telephone_number": "832-512-5377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANYAMA",
        "first_name": "KAPILI",
        "middle_name": "DAUDA",
        "name_prefix": "Mr.",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-19",
        "last_updated": "2012-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "761809",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "720688",
            "primary": false
        }
    ],
    "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 Jun 19, 2012; 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.