Individual provider Active NPI

Okiemute Charles Odeghe, FNP -C

  • Nurse Practitioner
  • Hanford, CA
National Provider Identifier
1376062638
Registry record updated Sep 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95007464 Issued in CA
Practice address
115 Mall Dr
Hanford, CA 93230-5786
Phone
(559) 537-1670
NPI assigned
Sep 18, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95007464 CA Primary

Addresses

Primary practice location

115 Mall Dr
Hanford, CA 93230-5786

Mailing address

115 Mall Dr
Hanford, CA 93230-5786
Phone (559) 537-1670

Other identifiers 1

IdentifierTypeStateIssuer
95007464MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20171019001153 CA Practitioner - Nurse Practitioner 2961778915 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - CaliforniaGroup PAC ID 6103739131, 1,278 clinicians

Practice addresses (Care Compare)

115 Mall Dr
Hanford, CA 93230-5786
Phone (559) 582-9000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California CurrentSince Sep 16, 2017 Accepting new patients
Cep America - California Current Accepting new patients
Wellnet360 Health CurrentSince Jan 1, 2026 Accepting new patients
Cep America-California CurrentSince Sep 16, 2017 Accepting new patients

Locations

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

115 Mall Dr
Hanford, CA 93230
Phone (559) 537-0550

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

Interoperability endpoints

  • Direct secure messaging: okiemute.odeghe.1@6501.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1505692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505692800000",
    "number": "1376062638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 MALL DR",
            "city": "HANFORD",
            "state": "CA",
            "postal_code": "932305786",
            "telephone_number": "559-537-1670",
            "fax_number": "559-537-1672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 MALL DR",
            "city": "HANFORD",
            "state": "CA",
            "postal_code": "932305786",
            "telephone_number": "559-537-1670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODEGHE",
        "first_name": "OKIEMUTE",
        "middle_name": "CHARLES",
        "credential": "FNP -C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-18",
        "last_updated": "2017-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95007464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95007464",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hanford, CA

Sources for this page

Verify at the official NPI Registry.