Individual provider Active NPI

Helen Epong Mboh, NP

  • Family Nurse Practitioner
  • Oklahoma, OK
National Provider Identifier
1962738666
Registry record updated Nov 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R0083300 Issued in OK
Practice address
1924 N. Portland Ave
Oklahoma, OK 73107
Phone
(405) 949-1552
Fax
(405) 949-1570
NPI assigned
Oct 30, 2009
Last updated
Nov 22, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R0083300 OK Primary

Addresses

Primary practice location

1924 N. Portland Ave
Oklahoma, OK 73107

Mailing address

1924 N. Portland Ave.
Oklahoma City, OK 73142-2524
Phone (405) 949-1552

Other identifiers 1

IdentifierTypeStateIssuer
R0083300OtherOKOKLAHOMA BOARD OF NURSING

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210223001784 OK Practitioner - Nurse Practitioner 5799957502 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Oklahoma College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1924 N Portland Ave
Oklahoma City, OK 73107-1532
Phone (405) 949-1552

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R0083300OKMDFamily Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1256860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321920000000",
    "number": "1962738666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1924 N. PORTLAND AVE.",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731422524",
            "telephone_number": "405-949-1552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1924 N. PORTLAND AVE",
            "city": "OKLAHOMA",
            "state": "OK",
            "postal_code": "73107",
            "telephone_number": "405-949-1552",
            "fax_number": "405-949-1570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MBOH",
        "first_name": "HELEN",
        "middle_name": "EPONG",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-30",
        "last_updated": "2011-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "R0083300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OKLAHOMA BOARD OF NURSING",
            "identifier": "R0083300",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma, OK

Sources for this page

Verify at the official NPI Registry.