Individual provider Active NPI

Malik Olasunkanmi Kuforiji, RN

  • Registered Nurse
  • Aurora, CO
National Provider Identifier
1477820306
Registry record updated Jun 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN-194877 Issued in CO
Practice address
27871 E Lakeview Dr
Aurora, CO 80016-2864
Phone
(720) 628-4593
Fax
(303) 219-3133
NPI assigned
Nov 21, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2022

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 RN-194877 CO Primary

Addresses

Primary practice location

27871 E Lakeview Dr
Aurora, CO 80016-2864

Mailing address

27871 E Lakeview Dr
Aurora, CO 80016-2864
Phone (720) 628-4593

Other identifiers 1

IdentifierTypeStateIssuer
RN-194877OtherCOCOLORADO STATE BOARD

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN-194877COMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
2875 W 33Rd LLC Current Accepting new patients
Havana Medical and Healthcare Services Current Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1321833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655683200000",
    "number": "1477820306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27871 E LAKEVIEW DR",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800162864",
            "telephone_number": "720-628-4593",
            "fax_number": "303-219-3133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27871 E LAKEVIEW DR",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800162864",
            "telephone_number": "720-628-4593",
            "fax_number": "303-219-3133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUFORIJI",
        "first_name": "MALIK",
        "middle_name": "OLASUNKANMI",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-21",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "RN-194877",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLORADO STATE BOARD",
            "identifier": "RN-194877",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2022; 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.