Individual provider Active NPI

Frances Uju Ogudebe

  • Registered Nurse
  • Bridgeport, CT
National Provider Identifier
1306355862
Registry record updated Sep 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
129669 Issued in CT
Practice address
968 Fairfield Ave
Bridgeport, CT 06605-1116
Phone
(203) 330-6000
NPI assigned
Sep 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 129669 CT Primary

Addresses

Primary practice location

968 Fairfield Ave
Bridgeport, CT 06605-1116

Mailing address

45 Fountain Terrace
New Haven, CT 06515
Phone (203) 668-1109

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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 1

Enrollment IDStateProvider typePAC IDDetails
I20171211001110 CT Practitioner - Nurse Practitioner 4587922000 Reassigns benefits to 1 organization
Practice locations: Hamden, CT

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Yale University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South-West Community Health Center IncGroup PAC ID 2466445200, 52 clinicians

Practice addresses (Care Compare)

46 Albion St
Bridgeport, CT 06605-2602
Phone (203) 332-3505

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
129669CTMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespring Healthcare Services LLC CurrentSince Feb 2, 2020 Accepting new patients
South-West Community Health Center, Inc CurrentSince Sep 26, 2017 Accepting new patients

Locations

968 Fairfield Ave
Bridgeport, CT 06605

510 Clinton Ave
Bridgeport, CT 06605
Phone (203) 366-4000

46 Albion St
Bridgeport, CT 06605
Phone (203) 332-3155

3074 Whitney Ave
Bldg 1
Hamden, CT 06518
Phone (203) 230-2800

Interoperability endpoints

  • Direct secure messaging: fogudebe577517@direct.ochin.org

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": "1506470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506470400000",
    "number": "1306355862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 FOUNTAIN TERRACE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06515",
            "telephone_number": "203-668-1109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "968 FAIRFIELD AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066051116",
            "telephone_number": "203-330-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGUDEBE",
        "first_name": "FRANCES",
        "middle_name": "UJU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-27",
        "last_updated": "2017-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "129669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.