Nicodemus Wuantai Naimodu, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

1001356 Issued in TX

Practice address

3708 20TH St Ste a
Lubbock, TX 79410-1228

Phone

(806) 744-8999

NPI assigned

Jul 7, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

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

• Lakeview Homecare LLC

  • Assisted Living Facility
  • Andover, MN
  • NPI 1558233783
  NPD Authorized official

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

{
    "created_epoch": "1594080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594080000000",
    "number": "1669090619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5016 HANOVER ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794161235",
            "telephone_number": "806-782-9177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3708 20TH ST STE A",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101228",
            "telephone_number": "806-744-8999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAIMODU",
        "first_name": "NICODEMUS",
        "middle_name": "WUANTAI",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-07",
        "last_updated": "2020-07-07",
        "certification_date": "2020-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "1001356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Myers, AU.D.
• Kyhl E Myers, MOT, OTR
• Nabil M. Attaya, M D PA
• Nadene J Tipton DDS, Ms
• Laszlo Nagy, M.D.
• Miguel Christian Najera, PA-C
• Amy Najjar, OTR
• Brent Boye Nall, M.D.
• Venkata Ramana Reddy Nalla
• Chetan Kumar Nanjegowda, M.D

• Registered Nurse in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Registered Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2020; 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.