Clive Nkafu Fomenky

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

132880 Issued in OH

Practice address

4613 Cutlass Dr
Englewood, OH 45322-2515

Phone

(937) 248-6394

NPI assigned

Jun 29, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Haven Healthkare Services

  • Home Health Agency
  • Dayton, OH
  • NPI 1235900416
  NPD Authorized official
• Serene Healthcare Services, LLC.

  • Home Health Agency
  • Englewood, OH
  • NPI 1760909923
  NPD Authorized official
• Admira Healthcare Services,LLC

  • Home Health Agency
  • Englewood, OH
  • NPI 1477980399
  NPD (past) Authorized official

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

{
    "created_epoch": "1309305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309305600000",
    "number": "1811284797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4613 CUTLASS DR",
            "city": "ENGLEWOOD",
            "state": "OH",
            "postal_code": "453222515",
            "telephone_number": "937-248-6394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4613 CUTLASS DR",
            "city": "ENGLEWOOD",
            "state": "OH",
            "postal_code": "453222515",
            "telephone_number": "937-248-6394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOMENKY",
        "first_name": "CLIVE",
        "middle_name": "NKAFU",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-29",
        "last_updated": "2011-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "132880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• First Choice Home Health Care
• Martika Fisher, PA
• Melissa Ann Fitzgerald
• Sarah E Focken, LSW
• Tonya Folley
• Seth Clayton Foote, PHYSICIAN ASSISTANT
• Forefront Dermatology, S.C.
• Ryan Sterling Foster, M.D.
• West N. Foster, NP
• Foundations Total Care LLC

• Licensed Practical Nurse in Englewood, OH
• Providers in Englewood, OH by specialty
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2011; 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.