Olusola Awodu, RN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN2297551 Issued in MA

Practice address

500 N Main St Ste C2ND
Randolph, MA 02368-6700

Phone

(857) 247-0263

NPI assigned

Nov 11, 2020

Last updated

Nov 20, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bay Cove Human Services, Inc

  • Community/Behavioral Health Agency
  • Boston, MA
  • NPI 1386702264

  Single Specialty

  Medicare reassignment NPD
• Bay Cove Human Services Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hyannis, MA
  • NPI 1386355519

  Single Specialty

  NPD
• Bay Cove Human Services, Inc

  • Community/Behavioral Health Agency
  • Boston, MA
  • NPI 1497981591

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1605052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637366400000",
    "number": "1063014496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N MAIN ST STE C2ND",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023686700",
            "telephone_number": "857-247-0263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N MAIN ST STE C2ND",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023686700",
            "telephone_number": "857-247-0263"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "66 Canal St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021142002",
            "country_code": "US",
            "telephone_number": "617-371-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AWODU",
        "first_name": "OLUSOLA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-11",
        "last_updated": "2021-11-20",
        "certification_date": "2021-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2297551",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2297551",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Asztalos, BCBA, L.A.B.A. ,M.ED
• Maudeline Aubourg, BCBA
• Ruth Aubourg
• Jessica Avila
• Kenneth Awasung, PHARMD
• Briana Ayala
• Pascale Azor
• Chidiebere Azuaru
• Chester Ryan Ramirez Azurin, MSPT
• Mariama Ba

• Psychiatric/Mental Health Nurse Practitioner in Randolph, MA
• Providers in Randolph, MA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.