Individual provider Active NPI

Bassey Kubiangha Oluyemi, R. N

  • Registered Nurse
  • Staten Island, NY
National Provider Identifier
1376880625
Registry record updated Jan 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
656031 Issued in NY
Practice address
35 Holland Ave
Apt. 11D
Staten Island, NY 10303-1219
Phone
(347) 857-5698
NPI assigned
Jan 7, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2013

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 656031 NY Primary
Contractor 171W00000X 656031 NY
Home Health Agency 251E00000X 656031 NY
Adult Companion 372600000X 656031 NY

Addresses

Primary practice location

35 Holland Ave
Apt. 11D
Staten Island, NY 10303-1219

Mailing address

35 Holland Ave
Apt. 11D
Staten Island, NY 10303-1219
Phone (347) 857-5698

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
656031NYMDAdult Companion

NPI Registry JSON

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

{
    "created_epoch": "1357516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357516800000",
    "number": "1376880625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 HOLLAND AVE",
            "address_2": "APT. 11D",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103031219",
            "telephone_number": "347-857-5698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 HOLLAND AVE",
            "address_2": "APT. 11D",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103031219",
            "telephone_number": "347-857-5698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLUYEMI",
        "first_name": "BASSEY",
        "middle_name": "KUBIANGHA",
        "credential": "R. N",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-07",
        "last_updated": "2013-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "656031",
            "primary": true
        },
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "NY",
            "license": "656031",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NY",
            "license": "656031",
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": "NY",
            "license": "656031",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.