Individual provider Active NPI

Catherine Olubummo, NP

  • Nurse Practitioner
  • Mahopac, NY
National Provider Identifier
1992825913
Registry record updated May 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
357386 Issued in NY
Practice address
110 Scout Hill Rd
Mahopac, NY 10541-2544
Phone
(914) 490-6199
Fax
(845) 519-6502
NPI assigned
Mar 31, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 357386 NY Primary

Addresses

Primary practice location

110 Scout Hill Rd
Mahopac, NY 10541-2544

Mailing address

110 Scout Hill Rd
Mahopac, NY 10541-2544
Phone (914) 490-6199

Other identifiers 1

IdentifierTypeStateIssuer
1992825913OtherNYNPI

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
357386NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
NP in Family Health, P.C. Past Accepting new patients
Gericine Solutions Nurse Practitioner Past Accepting new patients

Organizations & group practices 2

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": "1175299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210550400000",
    "number": "1992825913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 SCOUT HILL RD",
            "city": "MAHOPAC",
            "state": "NY",
            "postal_code": "105412544",
            "telephone_number": "914-490-6199",
            "fax_number": "845-519-6502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 SCOUT HILL RD",
            "city": "MAHOPAC",
            "state": "NY",
            "postal_code": "105412544",
            "telephone_number": "914-490-6199",
            "fax_number": "845-519-6502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLUBUMMO",
        "first_name": "CATHERINE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-31",
        "last_updated": "2008-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "357386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1992825913",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mahopac, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2008; 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.