Individual provider Active NPI

Michael O. Olosunde, LPN

  • Licensed Practical Nurse
  • Brooklyn, NY
National Provider Identifier
1912151085
Registry record updated Nov 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
288166-1 Issued in NY
Practice address
950 Fulton St
Apt 22
Brooklyn, NY 11238-8201
Phone
(347) 515-8552
NPI assigned
Nov 15, 2008
Last updated
Nov 30, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 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 288166-1 NY Primary

Addresses

Primary practice location

950 Fulton St
Apt 22
Brooklyn, NY 11238-8201

Mailing address

950 Fulton St
Apt 22
Brooklyn, NY 11238-8201
Phone (347) 515-8552

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
288166-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1226707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480464000000",
    "number": "1912151085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 FULTON ST",
            "address_2": "APT 22",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112388201",
            "telephone_number": "347-515-8552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 FULTON ST",
            "address_2": "APT 22",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112388201",
            "telephone_number": "347-515-8552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLOSUNDE",
        "first_name": "MICHAEL",
        "middle_name": "O.",
        "name_prefix": "Mr.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-15",
        "last_updated": "2016-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "288166-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.