Individual provider Active NPI

Obiamaka Regina Ntukogu, RN

  • Registered Nurse
  • Dorchester, MA
National Provider Identifier
1801972724
Registry record updated Dec 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
212688 Issued in MA
Practice address
1140 Dorchester Ave
Dorchester, MA 02125-3305
Phone
(617) 288-0970
Fax
(617) 474-0757
NPI assigned
Oct 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 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 212688 MA Primary

Addresses

Primary practice location

1140 Dorchester Ave
Dorchester, MA 02125-3305

Mailing address

10 Midland St
Brockton, MA 02301-1768
Phone (508) 243-7181

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
212688MAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Upham'S Corner Health Committee, Inc. Past Accepting new patients

Organizations & group practices 1

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": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262044800000",
    "number": "1801972724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 MIDLAND ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011768",
            "telephone_number": "508-243-7181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 DORCHESTER AVE",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021253305",
            "telephone_number": "617-288-0970",
            "fax_number": "617-474-0757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NTUKOGU",
        "first_name": "OBIAMAKA",
        "middle_name": "REGINA",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2009-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "212688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorchester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 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.