Independent

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

PN.155289-M-IV Issued in OH

Legal business name

INDEPENDENT

Practice address

6406 Busch Blvd Apt 461
Columbus, OH 43229-1853

Phone

(216) 313-0897

NPI assigned

Apr 16, 2014

Organization subpart

No

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

Authorized official

Name

Elvis Mbunya

Title

L.P.N

Phone

(216) 313-0897

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1397606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397606400000",
    "number": "1922428036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6406 BUSCH BLVD APT 461",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432291853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6406 BUSCH BLVD APT 461",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432291853",
            "telephone_number": "216-313-0897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-16",
        "last_updated": "2014-04-16",
        "status": "A",
        "authorized_official_last_name": "MBUNYA",
        "authorized_official_first_name": "ELVIS",
        "authorized_official_title_or_position": "L.P.N",
        "authorized_official_telephone_number": "216-313-0897"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "OH",
            "license": "PN.155289-M-IV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Care Home Facility in Columbus, OH
• Providers in Columbus, OH by specialty
• Adult Care Home Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2014; 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.