Active NPI
Ibezim Iwu, RN
- Registered Nurse
- Jamaica, NY
National Provider Identifier
1972904613
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 685605-1
- Practice address
- 13212 159TH St
Jamaica, NY 11434-2926 - Phone
- (718) 506-2294
- NPI assigned
- Sep 12, 2014
- Last updated
- Sep 12, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 685605-1 | NY | Primary |
Addresses
Primary practice location
13212 159TH St
Jamaica, NY 11434-2926
Mailing address
13212 159TH St
Jamaica, NY 11434-2926
Phone (718) 506-2294
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 143945458 | Other | NY | NYS |
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 685605-1 | NY | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410480000000",
"number": "1972904613",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13212 159TH ST",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114342926",
"telephone_number": "718-506-2294"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13212 159TH ST",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114342926",
"telephone_number": "718-506-2294"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IWU",
"first_name": "IBEZIM",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-09-12",
"last_updated": "2014-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "685605-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NYS",
"identifier": "143945458",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jamaica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.