Individual provider Active NPI

Nana Yeboah

  • Psychiatric/Mental Health Nurse Practitioner
  • Summit, NJ
National Provider Identifier
1871323980
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ15096700 Issued in NJ
Practice address
99 Beauvoir Ave
Summit, NJ 07901-3533
Phone
(862) 452-9248
NPI assigned
Aug 5, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 26NJ15096700 NJ Primary

Addresses

Primary practice location

99 Beauvoir Ave
Summit, NJ 07901-3533

Mailing address

99 Beauvoir Ave
Summit, NJ 07901-3533

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
26NJ15096700NJMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1722816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1871323980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 BEAUVOIR AVE",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079013533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 BEAUVOIR AVE",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079013533",
            "telephone_number": "862-452-9248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEBOAH",
        "first_name": "NANA",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-05",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ15096700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summit, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; 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.