Individual provider Active NPI

Isaac Abiola Popoola

  • Registered Nurse
  • Newark, NJ
National Provider Identifier
1629377445
Registry record updated Mar 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
26NR11395600 Issued in NJ
Practice address
357 Schley Aptb4
Newark, NJ 07112
Phone
(862) 237-8228
NPI assigned
Mar 18, 2011
Last updated
Mar 18, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 26NR11395600 NJ Primary
Registered Nurse 163W00000X 546207-1 NY

Addresses

Primary practice location

357 Schley Aptb4
Newark, NJ 07112

Mailing address

357 Schley St Apt B4
Newark, NJ 07112-1036
Phone (862) 237-8228

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
26NR11395600NJMDRegistered Nurse
546207-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1300406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300406400000",
    "number": "1629377445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "357 SCHLEY ST APT B4",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071121036",
            "telephone_number": "862-237-8228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "357 SCHLEY APTB4",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "07112",
            "telephone_number": "862-237-8228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPOOLA",
        "first_name": "ISAAC",
        "middle_name": "ABIOLA",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-18",
        "last_updated": "2011-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR11395600",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "546207-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2011; 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.