Individual provider Active NPI

Annemarie Osondu Odo, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1083235691
Registry record updated May 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP145857 Issued in TX
Practice address
9450 Skillman St Ste 120
Dallas, TX 75243-8235
Phone
(469) 569-3534
NPI assigned
May 5, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP145857 TX Primary

Addresses

Primary practice location

9450 Skillman St Ste 120
Dallas, TX 75243-8235

Mailing address

2633 Lake Meadow Dr
McKinney, TX 75071-2718
Phone (469) 569-3534

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210121001421 TX Practitioner - Nurse Practitioner 5890109565 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

15080 E Beltwood Pkwy
Suite 110
Addison, TX 75001-3724
Phone (469) 466-8595

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Semper Healthcare Services Psychiatric/Mental Health CurrentSince Jan 1, 2021 Accepting new patients
Semper Healthcare Services Inc PastSince May 10, 2020 Accepting new patients

Locations

15080 E Beltwood Pkwy
Ste 110
Addison, TX 75001
Phone (214) 293-6987

Organizations & group practices 3

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": "1588636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588636800000",
    "number": "1083235691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2633 LAKE MEADOW DR",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750712718",
            "telephone_number": "469-569-3534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9450 SKILLMAN ST STE 120",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752438235",
            "telephone_number": "469-569-3534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODO",
        "first_name": "ANNEMARIE",
        "middle_name": "OSONDU",
        "name_prefix": "Dr.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-05",
        "last_updated": "2020-05-05",
        "certification_date": "2020-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP145857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.