Individual provider Active NPI

Elizabeth Awino Odera, LPN

  • Licensed Practical Nurse
  • Rochester, NY
National Provider Identifier
1124557491
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
323024 Issued in NY
Practice address
132 Greystone Lane
Apt. 4
Rochester, NY 14618-4919
Phone
(585) 489-3209
NPI assigned
Jun 8, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 323024 NY Primary

Addresses

Primary practice location

132 Greystone Lane
Apt. 4
Rochester, NY 14618-4919

Mailing address

132 Greystone LN Apt 4
Rochester, NY 14618-4919
Phone (585) 489-3209

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

NPI Registry JSON

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

{
    "created_epoch": "1496880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1124557491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 GREYSTONE LN APT 4",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146184919",
            "telephone_number": "585-489-3209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 GREYSTONE LANE",
            "address_2": "APT. 4",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146184919",
            "telephone_number": "585-489-3209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODERA",
        "first_name": "ELIZABETH",
        "middle_name": "AWINO",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "323024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.