Active NPI
Ekor Wonah Odaji, PMHNP-BC
- Psychiatric/Mental Health Nurse Practitioner
- Middletown, DE
National Provider Identifier
1215750609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- AN-0025824
- Practice address
- 12 Pennington St Ste 100
Middletown, DE 19709-1026 - Phone
- (302) 724-1181
- NPI assigned
- Nov 4, 2024
- Last updated
- Nov 4, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | AN-0025824 | DE | Primary |
Addresses
Primary practice location
12 Pennington St Ste 100
Middletown, DE 19709-1026
Mailing address
590 Red Maple Rd
Smyrna, DE 19977-5294
Phone (908) 370-2902
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1000 Smyrna Clayton Blvd
Suite 5
Smyrna, DE 19977-2228
35 Newgate Cir
Smyrn, DE 19977-4039
5632 Whitfield Chapel Rd
Apt 203
Lanham, MD 20706-2554
8201 Corporate Dr
Suite 630
Hyattsville, MD 20785-2258
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AN-0025824 | DE | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1730678400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730678400000",
"number": "1215750609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "590 RED MAPLE RD",
"city": "SMYRNA",
"state": "DE",
"postal_code": "199775294",
"telephone_number": "908-370-2902"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 PENNINGTON ST STE 100",
"city": "MIDDLETOWN",
"state": "DE",
"postal_code": "197091026",
"telephone_number": "302-724-1181"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ODAJI",
"first_name": "EKOR",
"middle_name": "WONAH",
"credential": "PMHNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-11-04",
"last_updated": "2024-11-04",
"certification_date": "2024-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "DE",
"license": "AN-0025824",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Middletown, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.