Fredrick Nyabayo Bogonko

Primary specialty

Medical-Surgical Registered NurseTaxonomy code 163WM0705X

License

812434 Issued in CA

Practice address

1601 Vineyard Rd Apt 1623
Roseville, CA 95747-9132

Phone

(626) 272-6174

NPI assigned

May 27, 2021

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

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

{
    "created_epoch": "1622073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1841866183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 VINEYARD RD APT 1623",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "957479132",
            "telephone_number": "626-272-6174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 VINEYARD RD APT 1623",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "957479132",
            "telephone_number": "626-272-6174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGONKO",
        "first_name": "FREDRICK",
        "middle_name": "NYABAYO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-27",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "CA",
            "license": "812434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jayasree Bodagala, M.D.
• Zsolt Martin Bodai, RCP, RRT
• Lindsay Bodene
• Denise Ruth Bogard, M.D.
• Stephanie Boggs-Stewart
• George Oguta Bogonko
• Naomi Kerubo Bogonko, RN
• William J Bohan, DMD
• Lisa Bohrer, MS
• Ornella Bokoch

• Medical-Surgical Registered Nurse in Roseville, CA
• Providers in Roseville, CA by specialty
• Medical-Surgical Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; 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.