Collette Odibo, APRN-CNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN1058051 Issued in DC

Practice address

1818 New York Ave NE Ste 110
Washington, DC 20002-1849

Phone

(202) 489-0615

NPI assigned

Jan 13, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in DC, MD2 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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Standard Healthcare Plus LLCGroup PAC ID 7810391125, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Standard Healthcare Plus LLC

  • Multi-Specialty Clinic/Center
  • Clinton, MD
  • NPI 1245050038
  Medicare reassignment Care Compare group NPD
• Wellness Health Services, LLC

  dba The Ark of DC

  • Home Health Agency
  • Washington, DC
  • NPI 1033685953
  Medicare reassignment NPD
• Standard Healthcare Plus LLC

  • Neurology Physician
  • Clinton, MD
  • NPI 1790357044

  DC

  Medicare reassignment NPD
• Thrive Counseling LLC

  dba Thriveworks

  • Mental Health Counselor
  • Lynchburg, VA
  • NPI 1215181300

  DC

  Medicare reassignment NPD

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

{
    "created_epoch": "1263340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634256000000",
    "number": "1255661294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 GOLDEN HILL DR",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207212885",
            "telephone_number": "919-349-3177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 NEW YORK AVE NE STE 110",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200021849",
            "telephone_number": "202-489-0615"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11848 Francis Lewis Blvd",
            "address_purpose": "LOCATION",
            "city": "Cambria Heights",
            "state": "NY",
            "postal_code": "114111915",
            "country_code": "US",
            "telephone_number": "718-671-2100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ODIBO",
        "first_name": "COLLETTE",
        "credential": "APRN-CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-13",
        "last_updated": "2021-10-15",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "193806",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "DC",
            "license": "RN1058051",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "624985",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ajoke Odeyale
• Esther Folake Odeyale
• Olufunke T Odeyemi
• Michael Odhiambo
• Itohan U Odiase
• Stella Uche Odidika
• Osazee Conrad Odigie
• Rufina Nwanneka Odigwe, M.D
• Cecilia Chinwe Odilatu
• Maudline U Odilatu

• Psychiatric/Mental Health Nurse Practitioner in Washington, DC
• Providers in Washington, DC by specialty
• Psychiatric/Mental Health Nurse Practitioner in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2021; 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.

Verify at the official NPI Registry.