Active NPI
Omoike Idahosa, LPN
- Licensed Practical Nurse
- Bronx, NY
National Provider Identifier
1639444664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 284261-1
- Practice address
- 1118 Intervale Ave
Apt. 7H
Bronx, NY 10459-1199 - Phone
- (347) 498-1608
- NPI assigned
- Mar 8, 2012
- Last updated
- Mar 8, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 284261-1 | NY | Primary |
Addresses
Primary practice location
1118 Intervale Ave
Apt. 7H
Bronx, NY 10459-1199
Mailing address
1118 Intervale Ave
Apt. 7H
Bronx, NY 10459-1199
Phone (347) 498-1608
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
| License | State | Type | Specialty |
|---|---|---|---|
| 284261-1 | NY | MD | Critical Care Medicine (Internal Medicine) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1331164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1331164800000",
"number": "1639444664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1118 INTERVALE AVE",
"address_2": "APT. 7H",
"city": "BRONX",
"state": "NY",
"postal_code": "104591199",
"telephone_number": "347-498-1608"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1118 INTERVALE AVE",
"address_2": "APT. 7H",
"city": "BRONX",
"state": "NY",
"postal_code": "104591199",
"telephone_number": "347-498-1608"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IDAHOSA",
"first_name": "OMOIKE",
"name_prefix": "Mr.",
"credential": "LPN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-03-08",
"last_updated": "2012-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "NY",
"license": "284261-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Mar 8, 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.