Patience Ogwa Odupelu

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

0001231622 Issued in VA

Practice address

4222 Moomaw Ave NW
Roanoke, VA 24017-4314

Phone

(540) 613-0757

NPI assigned

Jan 11, 2020

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

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Evergreen Assisted Living Community LLC

  dba Evergreen Group Home Services

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Roanoke, VA
  • NPI 1780206250
  NPD Authorized official

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

{
    "created_epoch": "1578700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578700800000",
    "number": "1396385928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4222 MOOMAW AVE NW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240174314",
            "telephone_number": "540-613-0757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4222 MOOMAW AVE NW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240174314",
            "telephone_number": "540-613-0757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODUPELU",
        "first_name": "PATIENCE",
        "middle_name": "OGWA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-11",
        "last_updated": "2020-01-11",
        "certification_date": "2020-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001231622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracy B. Ochalek
• Laila Ochana, DDS
• James Christian Oconnell, MP.T.
• Sherri Schwab Odat
• Oddyssey IV, LLC (Center for Advance Imaging)
• Casey Jane Baker Ogden, LCSW
• Jennifer Gwyn Oginz, LPC
• Chinomso Daniel Ogumerem
• Jayson Ohler, PHARM D
• Chinaza Jacinta Okafor

• Registered Nurse in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Registered Nurse in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2020; 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.