Individual provider Active NPI

Emmanuel Chukwuemeka Ogbonnaya, LPN

  • Registered Nurse
  • Bronx, NY
National Provider Identifier
1710200837
Registry record updated Apr 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
655546 Issued in NY
Practice address
2753 Sexton PL
Bronx, NY 10469-5203
Phone
(646) 996-5911
NPI assigned
Mar 3, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 296512 NY
Registered Nurse 163W00000X 655546 NY Primary

Addresses

Primary practice location

2753 Sexton PL
Bronx, NY 10469-5203

Mailing address

35 Beech CT
Fishkill, NY 12524
Phone (646) 996-5911

Other identifiers 1

IdentifierTypeStateIssuer
296512OtherNYLPN LICENSE

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
655546NYMDRegistered Nurse
296512NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1267574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397433600000",
    "number": "1710200837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 BEECH CT",
            "city": "FISHKILL",
            "state": "NY",
            "postal_code": "12524",
            "telephone_number": "646-996-5911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2753 SEXTON PL",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104695203",
            "telephone_number": "646-996-5911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGBONNAYA",
        "first_name": "EMMANUEL",
        "middle_name": "CHUKWUEMEKA",
        "name_prefix": "Mr.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-03",
        "last_updated": "2014-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "296512",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "655546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPN LICENSE",
            "identifier": "296512",
            "state": "NY"
        }
    ],
    "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 Apr 14, 2014; 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.