Individual provider Active NPI

Elizabeth Nyako Odoom, FNP

  • Nurse Practitioner
  • Centreville, VA
National Provider Identifier
1386980654
Registry record updated Nov 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0024170486 Issued in VA
Practice address
6201 Centreville Rd Ste 200
Centreville, VA 20121-2626
Phone
(703) 830-5600
Fax
(703) 830-6942
NPI assigned
Dec 14, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024170486 VA
Nurse Practitioner 363L00000X 0024170486 VA Primary

Addresses

Primary practice location

6201 Centreville Rd Ste 200
Centreville, VA 20121-2626

Mailing address

PO Box 37174
Baltimore, MD 21297-3174
Phone (571) 423-5699

Other practice location 1

3300 Gallows Rd
Falls Church, VA 22042-3307
Phone (703) 776-7443

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130221000395 DC Practitioner - Nurse Practitioner 7517112659 Reassigns benefits to 3 organizations
I20160620000322 VA Practitioner - Nurse Practitioner 7517112659 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inova Ucc LLCGroup PAC ID 7012385040, 158 clinicians
Inova Health Care ServicesGroup PAC ID 2466351093, 1,821 clinicians

Practice addresses (Care Compare)

180 Maple Ave W
Vienna, VA 22180-5727
Phone (703) 938-5300

24801 Pinebrook Rd
Suite 110
Chantilly, VA 20152-4113
Phone (703) 722-2500

3300 Gallows Rd
Falls Church, VA 22042-3307
Phone (703) 698-2740

6201 Centreville Rd
Suite 200
Centreville, VA 20121-2626
Phone (571) 549-8577

Hospital & facility affiliations

  • Inova Fairfax Hospital Hospital, Falls Church, VA, CCN 490063

Merit-based Incentive Payment System (MIPS)

Final score
88.6 of 100Reported as group
Quality
84.42
Promoting interoperability
100
Improvement activities
40
Cost
77.58

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince May 22, 2016 Accepting new patients
Inova Health Care Services CurrentSince Feb 18, 2013 Accepting new patients
Inova Health Care Services CurrentSince Feb 18, 2013 Accepting new patients
Inova Ucc LLC CurrentSince Nov 15, 2022 Accepting new patients

Locations

6218 N Kings Hwy
Alexandria, VA 22303

2501 Parkers Ln
Alexandria, VA 22306
Phone (703) 664-7000

20070 Ashbrook Commons Plz
Ashburn, VA 20147
Phone (571) 223-0517

6201 Centreville Rd
Ste 200
Centreville, VA 20121
Phone (703) 830-5600

24801 Pinebrook Rd
Ste 110
Chantilly, VA 20152
Phone (703) 722-2500

3300 Gallows Rd
Fl 1
Falls Church, VA 22042
Phone (703) 776-4005

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

7637 Linton Hall Rd
Gainesville, VA 20155
Phone (703) 743-7000

2425 Centreville Rd
Ste 7
Herndon, VA 20171
Phone (571) 376-4000

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

224 Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

44045 Riverside Pkwy
Leesburg, VA 20176
Phone (703) 858-6040

11800 Sunrise Valley Dr
Ste 500
Reston, VA 20191
Phone (703) 437-5977

1900 Gallows Rd
Ste 110
Vienna, VA 22182
Phone (703) 281-1265

180 Maple Ave W
Vienna, VA 22180
Phone (703) 938-5300

Interoperability endpoints

  • Direct secure messaging: eodoom15801@soc.inova.org

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 2

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": "1355443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1386980654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37174",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212973174",
            "telephone_number": "571-423-5699",
            "fax_number": "571-423-5698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6201 CENTREVILLE RD STE 200",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201212626",
            "telephone_number": "703-830-5600",
            "fax_number": "703-830-6942"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3300 Gallows Rd",
            "address_purpose": "LOCATION",
            "city": "Falls Church",
            "state": "VA",
            "postal_code": "220423307",
            "country_code": "US",
            "telephone_number": "703-776-7443",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ODOOM",
        "first_name": "ELIZABETH",
        "middle_name": "NYAKO",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-14",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024170486",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024170486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centreville, VA

Sources for this page

Verify at the official NPI Registry.