Individual provider Active NPI

Elitah M. Mukonka, RN

  • Registered Nurse
  • Bedford, OH
National Provider Identifier
1821266545
Registry record updated Feb 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN338000 Issued in OH
Practice address
179 Willard Ave
Bedford, OH 44146-2219
Phone
(440) 232-8103
NPI assigned
Feb 15, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2008

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 RN338000 OH Primary

Addresses

Primary practice location

179 Willard Ave
Bedford, OH 44146-2219

Mailing address

179 Willard Ave
Bedford, OH 44146-2219

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
RN338000OHMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1203033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203033600000",
    "number": "1821266545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 WILLARD AVE",
            "city": "BEDFORD",
            "state": "OH",
            "postal_code": "441462219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 WILLARD AVE",
            "city": "BEDFORD",
            "state": "OH",
            "postal_code": "441462219",
            "telephone_number": "440-232-8103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUKONKA",
        "first_name": "ELITAH",
        "middle_name": "M.",
        "name_prefix": "Miss",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-15",
        "last_updated": "2008-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN338000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2008; 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.