Individual provider Active NPI

Hezekiah Odi

  • Home Health Registered Nurse
  • Glen Burnie, MD
National Provider Identifier
1043075013
Registry record updated Feb 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
License
RN9544319 Issued in FL
Practice address
504 Springview CT
Glen Burnie, MD 21060-8346
Phone
(443) 848-4821
NPI assigned
Feb 19, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X RN9544319 FL Primary

Addresses

Primary practice location

504 Springview CT
Glen Burnie, MD 21060-8346

Mailing address

504 Springview CT
Glen Burnie, MD 21060-8346
Phone (443) 848-4821

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
RN9544319FLMDHome Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Outstanding Care Logistic LLC CurrentSince Mar 17, 2024 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1708300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1043075013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 SPRINGVIEW CT",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210608346",
            "telephone_number": "443-848-4821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 SPRINGVIEW CT",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210608346",
            "telephone_number": "443-848-4821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODI",
        "first_name": "HEZEKIAH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-02-19",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "FL",
            "license": "RN9544319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; 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.