Fidele Koumanimben, PN.151506-M-IV

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

PN.151506-M-IV Issued in OH

Practice address

5254 Camelot Dr Apt D
Fairfield, OH 45014-4022

Phone

(513) 497-8095

NPI assigned

May 20, 2014

Last updated

May 20, 2014By the provider in NPPES

Sex

Female

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fidelity Home Care LLC

  • Home Health Agency
  • Liberty Township, OH
  • NPI 1578333035
  NPD Authorized official

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

{
    "created_epoch": "1400544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400544000000",
    "number": "1861804221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5254 CAMELOT DR APT D",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450144022",
            "telephone_number": "513-497-8095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5254 CAMELOT DR APT D",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450144022",
            "telephone_number": "513-497-8095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUMANIMBEN",
        "first_name": "FIDELE",
        "credential": "PN.151506-M-IV",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-20",
        "last_updated": "2014-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN.151506-M-IV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca S Koehl, M.D.
• Isabel Kohn
• Charles Robert Konkus, RPH
• Brett L Kopp, PHARMD
• Kenneth H Koster, MD
• Kimberly Kratzer
• Jeffrey Joseph Krechting, MPT PHYSICAL THERAPY
• Douglas Krejsa, MD
• Kroger Limited Partnership I (Kroger Pharmacy)
• Prasad R Kudalkar, MD

• Licensed Practical Nurse in Fairfield, OH
• Providers in Fairfield, 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 May 20, 2014; 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.