Individual provider Active NPI

Enos Odede

  • General Practice Registered Nurse
  • Dallas, TX
National Provider Identifier
1245695477
Registry record updated Dec 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
777392 Issued in TX
Practice address
3773 Timberglen Rd Apt 805
Dallas, TX 75287-3719
Phone
(214) 862-2951
NPI assigned
Dec 14, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 777392 TX
General Practice Registered Nurse 163WG0000X 777392 TX Primary
Home Health Aide 374U00000X 777392 TX

Addresses

Primary practice location

3773 Timberglen Rd Apt 805
Dallas, TX 75287-3719

Mailing address

3773 Timberglen Rd Apt 805
Dallas, TX 75287-3719
Phone (214) 862-2951

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

State licenses

LicenseStateTypeSpecialty
777392TXMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1450051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450051200000",
    "number": "1245695477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3773 TIMBERGLEN RD APT 805",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752873719",
            "telephone_number": "214-862-2951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3773 TIMBERGLEN RD APT 805",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752873719",
            "telephone_number": "214-862-2951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODEDE",
        "first_name": "ENOS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-14",
        "last_updated": "2015-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "777392",
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "TX",
            "license": "777392",
            "primary": true
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "TX",
            "license": "777392",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2015; 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.