Individual provider Active NPI

Adeola A Okunola

  • Licensed Practical Nurse
  • Staten Island, NY
National Provider Identifier
1861989485
Registry record updated Apr 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
331518 Issued in NY
Practice address
350 Vanderbilt Ave Apt 5H
Staten Island, NY 10304-3533
Phone
(347) 238-8321
NPI assigned
Apr 19, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 331518 NY Primary

Addresses

Primary practice location

350 Vanderbilt Ave Apt 5H
Staten Island, NY 10304-3533

Mailing address

350 Vanderbilt Ave Apt 5H
Staten Island, NY 10304-3533
Phone (347) 238-8321

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

State licenses

LicenseStateTypeSpecialty
331518NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1524096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524096000000",
    "number": "1861989485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 VANDERBILT AVE APT 5H",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103043533",
            "telephone_number": "347-238-8321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 VANDERBILT AVE APT 5H",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103043533",
            "telephone_number": "347-238-8321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKUNOLA",
        "first_name": "ADEOLA",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-19",
        "last_updated": "2018-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "331518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2018; 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.