Priscah Ouma Odongo

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71009212A Issued in IN

Practice address

1001 Sturdy Rd
Valparaiso, IN 46383-4126

Phone

(219) 462-7173

Fax

(219) 462-7504

NPI assigned

Aug 21, 2019

Sex

Female

Sole proprietor

No

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 IN, MI2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Complexcare Medical Group Midwest H PLLC

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1457144933

  MI

  Medicare reassignment NPD
• Complexcare Medical Group Midwest M PLLC

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1528851607

  MI

  Medicare reassignment NPD
• Theoria Medical

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1609362375

  MI

  Medicare reassignment NPD

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

{
    "created_epoch": "1566345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566345600000",
    "number": "1194372409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 VALLEY DR",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463832520",
            "telephone_number": "219-413-5100",
            "fax_number": "219-465-9502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 STURDY RD",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463834126",
            "telephone_number": "219-462-7173",
            "fax_number": "219-462-7504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODONGO",
        "first_name": "PRISCAH",
        "middle_name": "OUMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-21",
        "last_updated": "2019-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28193924A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71009212A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Obstetrical and Gynecological Associates Lab, LLC
• Obstetrical and Gynecological Associates, Inc
• Eliana C Ochoa
• Rachel A Ochse, PSYD
• Benjamin Douglas Odham
• Oetter Family Medical Corp
• Off Hour Medical Services, Inc
• Olusola Ogundipe, M.D.
• Morgan Oiler-Negron, M.A.
• Chike Floyd Okolocha Jr., DO

• All providers in Valparaiso, IN
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2019; 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.