Individual provider Active NPI

Olubunmi Olanipekun Ogunwale

  • Registered Nurse
  • Brentwood, NY
National Provider Identifier
1740514371
Registry record updated Sep 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
611147-1 Issued in NY
Practice address
12 East Dr Apt 2E
Brentwood, NY 11717-1139
Phone
(631) 357-3911
NPI assigned
Sep 30, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2009

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 611147-1 NY Primary

Addresses

Primary practice location

12 East Dr Apt 2E
Brentwood, NY 11717-1139

Mailing address

12 East Dr Apt 2E
Brentwood, NY 11717-1139
Phone (631) 357-3911

Other names 1

  • Mr. Olubunmi Olanipekun Ogunwale Professional 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
611147-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1254268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254268800000",
    "number": "1740514371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 EAST DR APT 2E",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117171139",
            "telephone_number": "631-357-3911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 EAST DR APT 2E",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117171139",
            "telephone_number": "631-357-3911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGUNWALE",
        "first_name": "OLUBUNMI",
        "middle_name": "OLANIPEKUN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-30",
        "last_updated": "2009-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "611147-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OLUBUNMI",
            "last_name": "OGUNWALE",
            "middle_name": "OLANIPEKUN",
            "prefix": "MR.",
            "credential": "RN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Brentwood, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2009; 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.