Active NPI
Fungai Mumbiro
- Rehabilitation Registered Nurse
- Canton, MI
National Provider Identifier
1447830708
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Registered Nurse
- License
- 4704304306
- Practice address
- 43825 Michigan Ave
Canton, MI 48188-2551 - Phone
- (248) 643-0700
- NPI assigned
- Apr 12, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Rehabilitation Registered Nurse | 163WR0400X | 4704304306 | MI | Primary |
Addresses
Primary practice location
43825 Michigan Ave
Canton, MI 48188-2551
Mailing address
43825 Michigan Ave
Canton, MI 48188-2551
Phone (248) 643-0070
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 |
|---|---|---|---|
| 4704304306 | MI | MD | Rehabilitation Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618185600000",
"number": "1447830708",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "43825 MICHIGAN AVE",
"city": "CANTON",
"state": "MI",
"postal_code": "481882551",
"telephone_number": "248-643-0070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "43825 MICHIGAN AVE",
"city": "CANTON",
"state": "MI",
"postal_code": "481882551",
"telephone_number": "248-643-0700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUMBIRO",
"first_name": "FUNGAI",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-04-12",
"last_updated": "2021-04-12",
"certification_date": "2021-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "163WR0400X",
"taxonomy_group": "",
"desc": "Registered Nurse, Rehabilitation",
"state": "MI",
"license": "4704304306",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canton, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.