Individual provider Active NPI

Magdalene O Omorebu

  • Registered Nurse
  • Mechanicsburg, PA
National Provider Identifier
1629891403
Registry record updated Nov 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
709881 Issued in PA
Practice address
381 Reserve LN
Mechanicsburg, PA 17050-8004
Phone
(336) 457-2203
NPI assigned
Nov 1, 2024
Last updated
Nov 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 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 709881 PA Primary

Addresses

Primary practice location

381 Reserve LN
Mechanicsburg, PA 17050-8004

Mailing address

381 Reserve LN
Mechanicsburg, PA 17050-8004
Phone (336) 457-2203

Other names 1

  • Magdalene O Nze 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

State licenses

LicenseStateTypeSpecialty
709881PAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Safehaven Enterprises LLC CurrentSince Nov 24, 2024 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1730419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730419200000",
    "number": "1629891403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "381 RESERVE LN",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170508004",
            "telephone_number": "336-457-2203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "381 RESERVE LN",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170508004",
            "telephone_number": "336-457-2203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMOREBU",
        "first_name": "MAGDALENE",
        "middle_name": "O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-01",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "709881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAGDALENE",
            "last_name": "NZE",
            "middle_name": "O",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mechanicsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.