Individual provider Active NPI

Mamusu Sesay, LPN

  • Licensed Practical Nurse
  • Front Royal, VA
National Provider Identifier
1689164261
Registry record updated Aug 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LP48908 Issued in MD
Practice address
116 E Main St
Front Royal, VA 22630-3337
Phone
(800) 601-0790
Fax
(571) 441-0861
NPI assigned
May 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LP48908 MD Primary

Addresses

Primary practice location

116 E Main St
Front Royal, VA 22630-3337

Mailing address

316 Warren Ave Ste 2
Front Royal, VA 22630-4480
Phone (804) 588-9178

Other identifiers 1

IdentifierTypeStateIssuer
1427550110MedicaidVA

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
LP48908MDMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Missionaries of Good Education and Healthcare, Inc. Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1526601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1689164261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 WARREN AVE STE 2",
            "city": "FRONT ROYAL",
            "state": "VA",
            "postal_code": "226304480",
            "telephone_number": "804-588-9178",
            "fax_number": "571-441-0861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 E MAIN ST",
            "city": "FRONT ROYAL",
            "state": "VA",
            "postal_code": "226303337",
            "telephone_number": "800-601-0790",
            "fax_number": "571-441-0861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SESAY",
        "first_name": "MAMUSU",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-18",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MD",
            "license": "LP48908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1427550110",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Front Royal, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2022; 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.