Individual provider Active NPI

Monique Akossiwa Komla Eklu, LVN

  • Licensed Vocational Nurse
  • San Antonio, TX
National Provider Identifier
1992272728
Registry record updated Oct 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
336678 Issued in TX
Practice address
4619 Everstone CRK
San Antonio, TX 78251-4717
Phone
(210) 544-4614
NPI assigned
Oct 30, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 336678 TX Primary

Addresses

Primary practice location

4619 Everstone CRK
San Antonio, TX 78251-4717

Mailing address

4619 Everstone CRK
San Antonio, TX 78251-4717
Phone (210) 544-4614

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
336678TXMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1540857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540857600000",
    "number": "1992272728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4619 EVERSTONE CRK",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782514717",
            "telephone_number": "210-544-4614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4619 EVERSTONE CRK",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782514717",
            "telephone_number": "210-544-4614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMLA EKLU",
        "first_name": "MONIQUE",
        "middle_name": "AKOSSIWA",
        "credential": "LVN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-30",
        "last_updated": "2018-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "336678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2018; 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.