Rachael M George Odutayo, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

103156 Issued in WV

Practice address

310 American Way Ste a
Weirton, WV 26062-4083

Phone

(304) 797-6410

Fax

(304) 797-6320

NPI assigned

Feb 26, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Cognitive Medicine Practice PLLC

  • Psychiatry Physician
  • Weirton, WV
  • NPI 1760789093
  NPD
• Arising Behavioral Health and Services LLC

  • Psychiatry Physician
  • Washington, DC
  • NPI 1225735848
  NPD

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

{
    "created_epoch": "1551139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666742400000",
    "number": "1396202479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 AMERICAN WAY STE A",
            "city": "WEIRTON",
            "state": "WV",
            "postal_code": "260624083",
            "telephone_number": "843-206-2031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 AMERICAN WAY STE A",
            "city": "WEIRTON",
            "state": "WV",
            "postal_code": "260624083",
            "telephone_number": "304-797-6410",
            "fax_number": "304-797-6320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGE ODUTAYO",
        "first_name": "RACHAEL",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-26",
        "last_updated": "2022-10-26",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "103156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph John Garan, PHARMD
• Mark Thomas Garan, AGACNP-BC
• Gary a Hanson MD Inc
• Divya Reddy Gavini, MD
• George M. Roig MD Inc
• George Gerbo III
• Melanie Renee Gerrard
• Ges Emergency Services Inc
• Tonya Jo Gianangeli
• Vincent Giardino

• Family Nurse Practitioner in Weirton, WV
• Providers in Weirton, WV by specialty
• Family Nurse Practitioner in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.