Individual provider Active NPI

Gloria Uchenna Belonwu

  • Registered Nurse
  • Sacramento, CA
National Provider Identifier
1770134017
Registry record updated Sep 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
598723 Issued in CA
Practice address
4600 Broadway
Sacramento, CA 95820-1527
Phone
(916) 875-1425
Fax
(916) 874-9214
NPI assigned
Sep 27, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2019

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 598723 CA Primary

Addresses

Primary practice location

4600 Broadway
Sacramento, CA 95820-1527

Mailing address

1539 Faletto Ave
Sacramento, CA 95835-1763

Other identifiers 1

IdentifierTypeStateIssuer
461363MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address belonwug@saccounty.net Direct

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
598723CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1569542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569542400000",
    "number": "1770134017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1539 FALETTO AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958351763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 BROADWAY",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958201527",
            "telephone_number": "916-875-1425",
            "fax_number": "916-874-9214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELONWU",
        "first_name": "GLORIA",
        "middle_name": "UCHENNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-27",
        "last_updated": "2019-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "598723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "461363",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "belonwug@saccounty.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4600 Broadway",
            "city": "Sacramento",
            "state": "CA",
            "country_code": "US",
            "postal_code": "958201527",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2019; 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.