Individual provider Active NPI

Karen Kay Nambo, RN

  • Registered Nurse
  • Rockford, IL
National Provider Identifier
1851174312
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
041368248 Issued in IL
Practice address
215 Easton Pkwy
Rockford, IL 61108-2216
Phone
(815) 962-0871
Fax
(815) 962-7895
NPI assigned
Aug 17, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

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 041368248 IL Primary

Addresses

Primary practice location

215 Easton Pkwy
Rockford, IL 61108-2216

Mailing address

215 Easton Pkwy
Rockford, IL 61108-2216
Phone (815) 962-0871

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
041368248ILMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Remedies Renewing Lives CurrentSince Aug 27, 2023 Accepting new patients
Remedies Renewing Lives CurrentSince Aug 27, 2023 Accepting new patients

Locations

215 Easton Pkwy
Rockford, IL 61108
Phone (815) 962-0871

Organizations & group practices 2

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": "1692230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1851174312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 EASTON PKWY",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082216",
            "telephone_number": "815-962-0871",
            "fax_number": "815-962-7895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 EASTON PKWY",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082216",
            "telephone_number": "815-962-0871",
            "fax_number": "815-962-7895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAMBO",
        "first_name": "KAREN",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-17",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041368248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

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

Verify at the official NPI Registry.