Individual provider Active NPI

Lynda Oden Larue, CRNP

  • Family Nurse Practitioner
  • Oneonta, AL
National Provider Identifier
1164949954
Registry record updated Apr 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1050053 Issued in AL
Practice address
150 Gilbreath Dr Ste 201
Oneonta, AL 35121-2827
Phone
(205) 274-8198
NPI assigned
Aug 23, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2018

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 1050053 AL Primary

Addresses

Primary practice location

150 Gilbreath Dr Ste 201
Oneonta, AL 35121-2827

Mailing address

370 Bullard Rd
Blountsville, AL 35031-3651
Phone (205) 288-1913

Other names 1

  • Lynda Fay Oden Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20171213002258 AL Practitioner - Nurse Practitioner 7416941547 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Vincent'S BlountGroup PAC ID 0547171662, 5 clinicians

Practice addresses (Care Compare)

150 Gilbreath Dr
Oneonta, AL 35121-2827
Phone (205) 274-8198

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1050053ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent'S Blount CurrentSince Oct 23, 2017 Accepting new patients
St Vincents Blount Current Accepting new patients
St. Vincent'S Blount CurrentSince Oct 23, 2017 Accepting new patients
St. Vincent'S Blount Past Accepting new patients

Locations

150 Gilbreath Dr
#201
Oneonta, AL 35121
Phone (205) 274-8198

150 Gilbreath Dr
Oneonta, AL 35121
Phone (205) 274-3000

Interoperability endpoints

  • Direct secure messaging: lynda.larue.1@9069.direct.athenahealth.com

Organizations & group practices 4

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": "1503446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522886400000",
    "number": "1164949954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 BULLARD RD",
            "city": "BLOUNTSVILLE",
            "state": "AL",
            "postal_code": "350313651",
            "telephone_number": "205-288-1913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 GILBREATH DR STE 201",
            "city": "ONEONTA",
            "state": "AL",
            "postal_code": "351212827",
            "telephone_number": "205-274-8198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARUE",
        "first_name": "LYNDA",
        "middle_name": "ODEN",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-23",
        "last_updated": "2018-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1050053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYNDA",
            "last_name": "ODEN",
            "middle_name": "FAY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oneonta, AL

Sources for this page

Verify at the official NPI Registry.