Individual provider Active NPI

Annah Njeri Mugambi

  • Licensed Practical Nurse
  • Brooklyn, NY
National Provider Identifier
1386179661
Registry record updated Apr 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
328212 Issued in NY
Practice address
861 Park Ave
Brooklyn, NY 11206-7300
Phone
(718) 828-2666
Fax
(718) 782-1538
NPI assigned
Apr 25, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2017

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 328212 NY Primary

Addresses

Primary practice location

861 Park Ave
Brooklyn, NY 11206-7300

Mailing address

5908 Cherry Hill Dr
Poughkeepsie, NY 12603-1705
Phone (845) 337-7455

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
328212NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1493078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493078400000",
    "number": "1386179661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5908 CHERRY HILL DR",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126031705",
            "telephone_number": "845-337-7455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "861 PARK AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112067300",
            "telephone_number": "718-828-2666",
            "fax_number": "718-782-1538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUGAMBI",
        "first_name": "ANNAH",
        "middle_name": "NJERI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-25",
        "last_updated": "2017-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "328212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2017; 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.