Individual provider Active NPI

Mukaila Abiodun Kafaru

  • Secured Medical Transport (VAN)
  • Cleveland, OH
National Provider Identifier
1629241468
Registry record updated Aug 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Secured Medical Transport (VAN)Taxonomy code 343800000X
License
187295 Issued in OH
Practice address
2490 Lee Blvd
Suite# 319 B
Cleveland, OH 44118-3204
Phone
(216) 371-7065
Fax
(216) 371-7060
NPI assigned
Apr 11, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Secured Medical Transport (VAN) 343800000X 187295 OH Primary

Addresses

Primary practice location

2490 Lee Blvd
Suite# 319 B
Cleveland, OH 44118-3204

Mailing address

2490 Lee Blvd
Suite# 319 B
Cleveland, OH 44118-1268
Phone (216) 371-7065

Other identifiers 1

IdentifierTypeStateIssuer
2800124MedicaidOH

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
187295OHMDSecured Medical Transport (VAN)

NPI Registry JSON

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

{
    "created_epoch": "1207872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282262400000",
    "number": "1629241468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2490 LEE BLVD",
            "address_2": "SUITE# 319 B",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441181268",
            "telephone_number": "216-371-7065",
            "fax_number": "216-371-7060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2490 LEE BLVD",
            "address_2": "SUITE# 319 B",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441183204",
            "telephone_number": "216-371-7065",
            "fax_number": "216-371-7060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAFARU",
        "first_name": "MUKAILA",
        "middle_name": "ABIODUN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-11",
        "last_updated": "2010-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343800000X",
            "taxonomy_group": "",
            "desc": "Secured Medical Transport (VAN)",
            "state": "OH",
            "license": "187295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2800124",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2010; 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.