Active NPI
Phyllis Agovi Banahene, RN
- Hemodialysis Registered Nurse
- Middletown, DE
National Provider Identifier
1811697253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hemodialysis Registered Nurse
- License
- L1-0034161
- Practice address
- 34 Watson LN
Middletown, DE 19709-9389 - Phone
- (302) 668-9851
- NPI assigned
- Mar 6, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hemodialysis Registered Nurse | 163WH0500X | L1-0034161 | DE | Primary |
Addresses
Primary practice location
34 Watson LN
Middletown, DE 19709-9389
Mailing address
34 Watson LN
Middletown, DE 19709-9389
Phone (302) 668-9851
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
| License | State | Type | Specialty |
|---|---|---|---|
| L1-0034161 | DE | MD | Hemodialysis Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Apex Dialysis LLC | Hemodialysis | Current | 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": "1678060800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678060800000",
"number": "1811697253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34 WATSON LN",
"city": "MIDDLETOWN",
"state": "DE",
"postal_code": "197099389",
"telephone_number": "302-668-9851"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34 WATSON LN",
"city": "MIDDLETOWN",
"state": "DE",
"postal_code": "197099389",
"telephone_number": "302-668-9851"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANAHENE",
"first_name": "PHYLLIS",
"middle_name": "AGOVI",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-03-06",
"last_updated": "2023-03-06",
"certification_date": "2023-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "163WH0500X",
"taxonomy_group": "",
"desc": "Registered Nurse, Hemodialysis",
"state": "DE",
"license": "L1-0034161",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middletown, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.