Individual provider Active NPI

Anne Alexis Fombu, R.N

  • Registered Nurse
  • Stoughton, MA
National Provider Identifier
1548445877
Registry record updated Jan 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
260896 Issued in MA
Practice address
32 Stratford Ave
Stoughton, MA 02072-4522
Phone
(617) 388-7704
NPI assigned
Jan 6, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2008

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 260896 MA Primary

Addresses

Primary practice location

32 Stratford Ave
Stoughton, MA 02072-4522

Mailing address

32 Stratford Ave
Stoughton, MA 02072-4522
Phone (617) 388-7704

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
260896MAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1199577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199577600000",
    "number": "1548445877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 STRATFORD AVE",
            "city": "STOUGHTON",
            "state": "MA",
            "postal_code": "020724522",
            "telephone_number": "617-388-7704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 STRATFORD AVE",
            "city": "STOUGHTON",
            "state": "MA",
            "postal_code": "020724522",
            "telephone_number": "617-388-7704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOMBU",
        "first_name": "ANNE",
        "middle_name": "ALEXIS",
        "credential": "R.N",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-06",
        "last_updated": "2008-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "260896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stoughton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2008; 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.