Active NPI
Callistus Nwabueze Nwamba
- Nurse's Aide
- Florissant, MO
National Provider Identifier
1376948034
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse's Aide
- License
- 129861
- Practice address
- 2799 Nottinghill Row
Apt J
Florissant, MO 63033-2409 - Phone
- (314) 536-0149
- NPI assigned
- Oct 23, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | 129861 | MO | Primary |
Addresses
Primary practice location
2799 Nottinghill Row
Apt J
Florissant, MO 63033-2409
Mailing address
2799 Nottinghill Row
Apt J
Florissant, MO 63033-2409
Phone (314) 536-0149
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9113902602 | Other | MO | UMR |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 129861 | MO | MD | Nurse's Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1414022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1414022400000",
"number": "1376948034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2799 NOTTINGHILL ROW",
"address_2": "APT J",
"city": "FLORISSANT",
"state": "MO",
"postal_code": "630332409",
"telephone_number": "314-536-0149"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2799 NOTTINGHILL ROW",
"address_2": "APT J",
"city": "FLORISSANT",
"state": "MO",
"postal_code": "630332409",
"telephone_number": "314-536-0149"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NWAMBA",
"first_name": "CALLISTUS",
"middle_name": "NWABUEZE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-10-23",
"last_updated": "2014-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "MO",
"license": "129861",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UMR",
"identifier": "9113902602",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Florissant, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.