Individual provider Active NPI

Bamikole Olojuomo

  • Licensed Practical Nurse
  • Queens Village, NY
National Provider Identifier
1619222700
Registry record updated Jul 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
296334 Issued in NY
Practice address
21714 103Rd Ave
Queens Village, NY 11429-1117
Phone
(718) 530-2526
NPI assigned
Jul 16, 2012
Last updated
Jul 16, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 296334 NY Primary

Addresses

Primary practice location

21714 103Rd Ave
Queens Village, NY 11429-1117

Mailing address

21714 103Rd Ave
Queens Village, NY 11429-1117
Phone (718) 530-2526

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

State licenses

LicenseStateTypeSpecialty
296334NYMDPhysical Medicine & Rehabilitation Physician

NPI Registry JSON

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

{
    "created_epoch": "1342396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342396800000",
    "number": "1619222700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21714 103RD AVE",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114291117",
            "telephone_number": "718-530-2526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21714 103RD AVE",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114291117",
            "telephone_number": "718-530-2526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLOJUOMO",
        "first_name": "BAMIKOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-16",
        "last_updated": "2012-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "296334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queens Village, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2012; 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.