Individual provider Active NPI

Obiageri Rita Odeyemi

  • Licensed Practical Nurse
  • Upper Marlboro, MD
National Provider Identifier
1326302787
Registry record updated Mar 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LPN1004886 Issued in DC
Practice address
11306 Kettering Way
Upper Marlboro, MD 20774-1554
Phone
(301) 379-8301
NPI assigned
Jul 1, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X
Licensed Practical Nurse 164W00000X LPN1004886 DC Primary

Addresses

Primary practice location

11306 Kettering Way
Upper Marlboro, MD 20774-1554

Mailing address

7600 Georgia Ave NW Ste 323
Washington, DC 20012-1616
Phone (027) 233-0602

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
LPN1004886DCMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1341100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521417600000",
    "number": "1326302787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 GEORGIA AVE NW STE 323",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200121616",
            "telephone_number": "027-233-0602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11306 KETTERING WAY",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207741554",
            "telephone_number": "301-379-8301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODEYEMI",
        "first_name": "OBIAGERI",
        "middle_name": "RITA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-01",
        "last_updated": "2018-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "DC",
            "license": "LPN1004886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upper Marlboro, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2018; 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.