Individual provider Active NPI

Emmanuel Ngulefac Nkengeh, CNP, FNP

  • Family Nurse Practitioner
  • Gahanna, OH
National Provider Identifier
1801207261
Registry record updated Feb 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.024075 Issued in OH
Practice address
313 Marjoram Dr
Gahanna, OH 43230-7027
Phone
(301) 300-1183
NPI assigned
May 19, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN.387140 OH
Family Nurse Practitioner 363LF0000X APRN.CNP.024075 OH Primary

Addresses

Primary practice location

313 Marjoram Dr
Gahanna, OH 43230-7027

Mailing address

313 Marjoram Dr
Gahanna, OH 43230-7027
Phone (301) 300-1183

Other practice location 1

1862 solera dr
columbus, OH 43229
Phone (301) 300-1183

Other names 1

  • Emmanuel N/a Nkengeh Ngulefac Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240705001819 OH Practitioner - Nurse Practitioner 2466996152 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN.CNP.024075OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alpha Recovery Center Registered Nurse CurrentSince May 7, 2024 Accepting new patients
Alpha Recovery Center PastSince May 7, 2024 Accepting new patients

Locations

3805 N High St
Ste 307
Columbus, OH 43214
Phone (614) 897-9252

Organizations & group practices 2

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": "1400457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549929600000",
    "number": "1801207261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 MARJORAM DR",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432307027",
            "telephone_number": "301-300-1183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 MARJORAM DR",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432307027",
            "telephone_number": "301-300-1183"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1862 solera dr",
            "address_purpose": "LOCATION",
            "city": "columbus",
            "state": "OH",
            "postal_code": "43229",
            "country_code": "US",
            "telephone_number": "301-300-1183",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NKENGEH",
        "first_name": "EMMANUEL",
        "middle_name": "NGULEFAC",
        "credential": "CNP, FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-19",
        "last_updated": "2019-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.387140",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.024075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMMANUEL",
            "last_name": "NKENGEH NGULEFAC",
            "middle_name": "N/A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gahanna, OH

Sources for this page

Verify at the official NPI Registry.