Anthony Kangethe

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

95208703 Issued in CA

Practice address

24259 Gazania Way
Lake Elsinore, CA 92532-2736

Phone

(951) 581-0127

NPI assigned

Feb 25, 2015

Last updated

Oct 10, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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": "1424822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602288000000",
    "number": "1467844647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24259 GAZANIA WAY",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925322736",
            "telephone_number": "951-581-0127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24259 GAZANIA WAY",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925322736",
            "telephone_number": "951-581-0127"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "42910 Avenida Amistad",
            "address_purpose": "LOCATION",
            "city": "Temecula",
            "state": "CA",
            "postal_code": "925923065",
            "country_code": "US",
            "telephone_number": "951-581-0127",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANGETHE",
        "first_name": "ANTHONY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-02-25",
        "last_updated": "2020-10-10",
        "certification_date": "2020-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95208703",
            "primary": true
        },
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "VN263721",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NA",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Registered Nurse in Lake Elsinore, CA
• Providers in Lake Elsinore, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.