Individual provider Active NPI

Stacey Lynn Odell, RN

  • Hemodialysis Registered Nurse
  • West Warwick, RI
National Provider Identifier
1003574294
Registry record updated Dec 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hemodialysis Registered NurseTaxonomy code 163WH0500X
License
RN40785 Issued in RI
Practice address
60 Dogwood Dr Apt 302
West Warwick, RI 02893-7541
Phone
(401) 225-1605
NPI assigned
Dec 4, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hemodialysis Registered Nurse 163WH0500X RN40785 RI Primary

Addresses

Primary practice location

60 Dogwood Dr Apt 302
West Warwick, RI 02893-7541

Mailing address

60 Dogwood Dr Apt 302
West Warwick, RI 02893-7541
Phone (401) 225-1605

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Warwick Direct

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

LicenseStateTypeSpecialty
RN40785RIMDHemodialysis Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1638576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638576000000",
    "number": "1003574294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 DOGWOOD DR APT 302",
            "city": "WEST WARWICK",
            "state": "RI",
            "postal_code": "028937541",
            "telephone_number": "401-225-1605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 DOGWOOD DR APT 302",
            "city": "WEST WARWICK",
            "state": "RI",
            "postal_code": "028937541",
            "telephone_number": "401-225-1605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODELL",
        "first_name": "STACEY",
        "middle_name": "LYNN",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-04",
        "last_updated": "2021-12-04",
        "certification_date": "2021-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Hemodialysis",
            "state": "RI",
            "license": "RN40785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Warwick",
            "affiliation": "N",
            "endpointDescription": "home",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "personal",
            "address_1": "60 Dogwood Dr Apt 302",
            "city": "West Warwick",
            "state": "RI",
            "country_code": "US",
            "postal_code": "028937541",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Warwick, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2021; 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.