Individual provider Active NPI

Naomi Kanyugi

  • Licensed Practical Nurse
  • Phoenix, AZ
National Provider Identifier
1376251322
Registry record updated Nov 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
277773 Issued in AZ
Practice address
1017 E Odeum LN
Phoenix, AZ 85040-1292
Phone
(703) 785-4583
NPI assigned
Nov 8, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 277773 AZ Primary

Addresses

Primary practice location

1017 E Odeum LN
Phoenix, AZ 85040-1292

Mailing address

1017 E Odeum LN
Phoenix, AZ 85040-1292
Phone (703) 785-4583

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

State licenses

LicenseStateTypeSpecialty
277773AZMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Adonai Tumaini Behavioral Health LLC CurrentSince Nov 20, 2022 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1667865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668124800000",
    "number": "1376251322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 E ODEUM LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850401292",
            "telephone_number": "703-785-4583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 E ODEUM LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850401292",
            "telephone_number": "703-785-4583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANYUGI",
        "first_name": "NAOMI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-08",
        "last_updated": "2022-11-11",
        "certification_date": "2022-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "AZ",
            "license": "277773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2022; 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.