Individual provider Active NPI

Chukwudi Oduah, CNP

  • Family Nurse Practitioner
  • Dayton, OH
National Provider Identifier
1114289501
Registry record updated Feb 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
COA.17970-NP Issued in OH
Practice address
1 Elizabeth PL
Suite D
Dayton, OH 45417-3445
Phone
(937) 222-2233
NPI assigned
Jun 12, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X COA.17970-NP OH Primary

Addresses

Primary practice location

1 Elizabeth PL
Suite D
Dayton, OH 45417-3445

Mailing address

1 Elizabeth PL
Suite D
Dayton, OH 45417-3445
Phone (937) 222-2233

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20181102002513 OH Practitioner - Nurse Practitioner 6608129986 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dayton Pain Center LLCGroup PAC ID 8123922887, 10 clinicians
CG Medical Associates IncGroup PAC ID 6608052196, 171 clinicians

Practice addresses (Care Compare)

1 Elizabeth PL
Dayton, OH 45417-3445
Phone (937) 222-2233

5915 N Main St
Dayton, OH 45415-3104
Phone (937) 278-3826

Hospital & facility affiliations

  • Kettering Health Dayton Hospital, Dayton, OH, CCN 360133
  • Miami Valley Hospital Hospital, Dayton, OH, CCN 360051

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
COA.17970-NPOHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CG Medical Associates Inc CurrentSince Dec 1, 2022 Accepting new patients
Dayton Pain Center LLC CurrentSince Oct 18, 2018 Accepting new patients

Locations

7300 Beechmont Ave
Cincinnati, OH 45230
Phone (513) 232-9100

1 Elizabeth Pl
Ste D
Dayton, OH 45417
Phone (937) 222-2233

5915 N Main St
Dayton, OH 45415
Phone (937) 278-3826

331 6th Ave
Sidney, OH 45365
Phone (937) 222-2233

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1339459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455580800000",
    "number": "1114289501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ELIZABETH PL",
            "address_2": "SUITE D",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454173445",
            "telephone_number": "937-222-2233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ELIZABETH PL",
            "address_2": "SUITE D",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454173445",
            "telephone_number": "937-222-2233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODUAH",
        "first_name": "CHUKWUDI",
        "name_prefix": "Mr.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-12",
        "last_updated": "2016-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA.17970-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.