Individual provider Active NPI

Ndem Amogu

  • Registered Nurse
  • Canton, OH
National Provider Identifier
1437038643
Registry record updated Sep 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
505385 Issued in OH
Practice address
5515 Severn Cir NW
Canton, OH 44708-3250
Phone
(443) 652-0123
Fax
(443) 652-0123
NPI assigned
Sep 1, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 505385 OH Primary

Addresses

Primary practice location

5515 Severn Cir NW
Canton, OH 44708-3250

Mailing address

5515 Severn Cir NW
Canton, OH 44708-3250
Phone (443) 652-0123

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
505385OHMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1756684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756684800000",
    "number": "1437038643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5515 SEVERN CIR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447083250",
            "telephone_number": "443-652-0123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5515 SEVERN CIR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447083250",
            "telephone_number": "443-652-0123",
            "fax_number": "443-652-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMOGU",
        "first_name": "NDEM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-09-01",
        "last_updated": "2025-09-01",
        "certification_date": "2025-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "505385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2025; 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.