Active NPI
Komitse Gbohla
- Private Vehicle
- Moline, IL
National Provider Identifier
1487444246
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Private Vehicle
- Practice address
- 3534 70TH St Apt 302
Moline, IL 61265-8236 - Phone
- (310) 866-5446
- NPI assigned
- May 7, 2025
- Last updated
- May 21, 2025
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Private Vehicle | 347C00000X | Primary |
Addresses
Primary practice location
3534 70TH St Apt 302
Moline, IL 61265-8236
Mailing address
3534 70TH St Apt 302
Moline, IL 61265-8236
Phone (310) 866-5446
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1746576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747785600000",
"number": "1487444246",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3534 70TH ST APT 302",
"city": "MOLINE",
"state": "IL",
"postal_code": "612658236",
"telephone_number": "310-866-5446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3534 70TH ST APT 302",
"city": "MOLINE",
"state": "IL",
"postal_code": "612658236",
"telephone_number": "310-866-5446"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GBOHLA",
"first_name": "KOMITSE",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-05-07",
"last_updated": "2025-05-21",
"certification_date": "2025-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "347C00000X",
"taxonomy_group": "",
"desc": "Private Vehicle",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moline, IL
- Sara Kathleen Garner
- Jane Ann Garrett, OTR/L
- Lynn M Garvin-Huntley, PH.D
- Taffy A. Gaston, LPC
- Ruth Gbadeyan
- General Surgery Associates, LLC
- Generations Womens Health S C
- Genesis Health System (Genesis Health Group)
- Genesis Health System (Genesis Health Group)
- Genesis Health System (Genesis Health Group)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.