Individual provider Active NPI

Keiruka Nwugwo

  • General Practice Registered Nurse
  • Syracuse, NY
National Provider Identifier
1740725191
Registry record updated Dec 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
712562-1 Issued in NY
Practice address
28 Westbrook Hills Dr
Syracuse, NY 13215-1803
Phone
(973) 937-1004
NPI assigned
Dec 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 712562-1 NY Primary

Addresses

Primary practice location

28 Westbrook Hills Dr
Syracuse, NY 13215-1803

Mailing address

28 Westbrook Hills Dr
Syracuse, NY 13215-1803
Phone (973) 937-1004

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
712562-1NYMDGeneral Practice Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1482278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482278400000",
    "number": "1740725191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 WESTBROOK HILLS DR",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132151803",
            "telephone_number": "973-937-1004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 WESTBROOK HILLS DR",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132151803",
            "telephone_number": "973-937-1004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWUGWO",
        "first_name": "KEIRUKA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-21",
        "last_updated": "2016-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "NY",
            "license": "712562-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2016; 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.