Active NPI
Mary Jule Odea Odonovan, RD, LDN
- Registered Dietitian
- Denver, CO
National Provider Identifier
1265995591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 4693
- Practice address
- 980 N Marion St
Denver, CO 80218-3015 - Phone
- (303) 919-1281
- NPI assigned
- Apr 12, 2019
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 4693 | MA | Primary |
Addresses
Primary practice location
980 N Marion St
Denver, CO 80218-3015
Mailing address
980 N Marion St
Denver, CO 80218-3015
Phone (303) 919-1281
Other practice location 1
80 1/2 Kinnaird St
Cambridge, MA 02139-3153
Phone (303) 919-1281
Other names 1
- Mary Jule Odea
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4693 | MA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Your Friendly Dietitian, LLC | Dietitian, Registered | Past | Accepting new patients |
| Marjorie Nolan Cohn LLC | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603324800000",
"number": "1265995591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "980 N MARION ST",
"city": "DENVER",
"state": "CO",
"postal_code": "802183015",
"telephone_number": "303-919-1281"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "980 N MARION ST",
"city": "DENVER",
"state": "CO",
"postal_code": "802183015",
"telephone_number": "303-919-1281"
}
],
"practiceLocations": [
{
"address_1": "80 1/2 Kinnaird St",
"address_purpose": "LOCATION",
"city": "Cambridge",
"state": "MA",
"postal_code": "021393153",
"country_code": "US",
"telephone_number": "303-919-1281",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ODONOVAN",
"first_name": "MARY JULE",
"middle_name": "ODEA",
"credential": "RD, LDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-12",
"last_updated": "2020-10-22",
"certification_date": "2020-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MA",
"license": "4693",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARY",
"last_name": "ODEA",
"middle_name": "JULE",
"credential": "RD, LDN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.