Individual provider Active NPI

Ndambou Mendy

  • Assisted Living Facility
  • Oshkosh, WI
National Provider Identifier
1912884784
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Practice address
4475 Soda Creek Rd
Oshkosh, WI 54901-1025
Phone
(920) 489-4771
NPI assigned
Aug 21, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X WI Primary

Addresses

Primary practice location

4475 Soda Creek Rd
Oshkosh, WI 54901-1025

Mailing address

N1145 Glennview Dr
Greenville, WI 54942-8782
Phone (920) 489-4771

Other names 1

  • Nyima Gibba Other name

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

Practice roles

OrganizationSpecialtyStatusNew patients
Teh-Khang Care LLC CurrentSince Oct 12, 2025 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1755734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1912884784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N1145 GLENNVIEW DR",
            "city": "GREENVILLE",
            "state": "WI",
            "postal_code": "549428782",
            "telephone_number": "920-489-4771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4475 SODA CREEK RD",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549011025",
            "telephone_number": "920-489-4771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDY",
        "first_name": "NDAMBOU",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-08-21",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NYIMA",
            "last_name": "GIBBA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Oshkosh, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2025; 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.