Individual provider Active NPI

Sherifat Olugbode

  • Licensed Practical Nurse
  • Staten Island, NY
National Provider Identifier
1881052223
Registry record updated Jan 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
322758 Issued in NY
Practice address
370 Mosel Ave
Staten Island, NY 10304-3435
Phone
(347) 837-9789
NPI assigned
Jan 31, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2016

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 322758 NY Primary

Addresses

Primary practice location

370 Mosel Ave
Staten Island, NY 10304-3435

Mailing address

370 Mosel Ave
Staten Island, NY 10304-3435
Phone (347) 837-9789

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
322758NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1454198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454198400000",
    "number": "1881052223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 MOSEL AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103043435",
            "telephone_number": "347-837-9789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 MOSEL AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103043435",
            "telephone_number": "347-837-9789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLUGBODE",
        "first_name": "SHERIFAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-31",
        "last_updated": "2016-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "322758",
            "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 Jan 31, 2016; 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.