Active NPI
Lauren Odenkirk
- Registered Dietitian
- Wooster, OH
National Provider Identifier
1275097834
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LD.08449
- Practice address
- 1761 Beall Ave
Wooster, OH 44691-2342 - Phone
- (330) 263-8196
- NPI assigned
- Jan 29, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 | LD.08449 | OH | Primary |
Addresses
Primary practice location
1761 Beall Ave
Wooster, OH 44691-2342
Mailing address
1185 Princehorn Ave NW
North Lawrence, OH 44666-9712
Phone (330) 987-5613
Other practice location 1
659 Boulevard St
Dover, OH 44622-2026
Phone (330) 364-0854
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707868800000",
"number": "1275097834",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1185 PRINCEHORN AVE NW",
"city": "NORTH LAWRENCE",
"state": "OH",
"postal_code": "446669712",
"telephone_number": "330-987-5613"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1761 BEALL AVE",
"city": "WOOSTER",
"state": "OH",
"postal_code": "446912342",
"telephone_number": "330-263-8196"
}
],
"practiceLocations": [
{
"address_1": "659 Boulevard St",
"address_purpose": "LOCATION",
"city": "Dover",
"state": "OH",
"postal_code": "446222026",
"country_code": "US",
"telephone_number": "330-364-0854",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ODENKIRK",
"first_name": "LAUREN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-01-29",
"last_updated": "2024-02-14",
"certification_date": "2024-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OH",
"license": "LD.08449",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wooster, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.