Individual provider Active NPI

Chizoba Ethyna Ukenna, RN

  • Registered Nurse
  • Bronx, NY
National Provider Identifier
1609610054
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
743918 Issued in NY
Practice address
772 E 233Rd St
Bronx, NY 10466-3172
Phone
(347) 843-0444
NPI assigned
Jun 20, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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 743918 NY Primary

Addresses

Primary practice location

772 E 233Rd St
Bronx, NY 10466-3172

Mailing address

3463 Fish Ave Apt 1a
Bronx, NY 10469-2281
Phone (607) 313-9807

Other practice location 1

1345 Southern Blvd Apt 2K
Bronx, NY 10459-1524
Phone (347) 721-5669

Other names 1

  • Chizoba Ethyna Brand Other name

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
743918NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Promise Home Care Agency Inc. PastSince Jun 23, 2024 Accepting new patients
Promise Home Care Agency, Inc PastSince Jun 23, 2024 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": "1718841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1609610054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3463 FISH AVE APT 1A",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104692281",
            "telephone_number": "607-313-9807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "772 E 233RD ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104663172",
            "telephone_number": "347-843-0444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1345 Southern Blvd Apt 2K",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104591524",
            "country_code": "US",
            "telephone_number": "347-721-5669",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UKENNA",
        "first_name": "CHIZOBA",
        "middle_name": "ETHYNA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-20",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "743918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHIZOBA",
            "last_name": "BRAND",
            "middle_name": "ETHYNA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; 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.