Virgilius Uzo Mbawuike

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

236261 Issued in MA

Practice address

10 Pinewood St
Mattapan, MA 02126-1020

Phone

(617) 233-5829

NPI assigned

Jan 9, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1231459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584662400000",
    "number": "1407093685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 PINEWOOD ST",
            "city": "MATTAPAN",
            "state": "MA",
            "postal_code": "021261020",
            "telephone_number": "617-233-5829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 PINEWOOD ST",
            "city": "MATTAPAN",
            "state": "MA",
            "postal_code": "021261020",
            "telephone_number": "617-233-5829"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "780 Albany St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021182755",
            "country_code": "US",
            "telephone_number": "857-654-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MBAWUIKE",
        "first_name": "VIRGILIUS",
        "middle_name": "UZO",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-09",
        "last_updated": "2020-03-20",
        "certification_date": "2020-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "236261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mattapan Community Health Center Inc
• Mattapan Dental, LLC
• Mattapan Medical Associates Inc
• Mattapan Smiles Youth Dentistry, LLC
• Mattapan Square Family Dental PC
• Heather McDade, DMD
• Michelle Katherine McDonagh, MSW
• Ann Marie McGuire, RN
• Mardi McMahon, RN
• Medical Center of Greater Mattapan

• Registered Nurse in Mattapan, MA
• Providers in Mattapan, MA by specialty
• Registered Nurse in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2020; 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.