Individual provider Active NPI

Odessa Marie Locicero, RN

  • Registered Nurse
  • Austin, TX
National Provider Identifier
1427552959
Registry record updated Mar 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
886680 Issued in TX
Practice address
1700 S Lamar Blvd
Austin, TX 78704-8962
Phone
(512) 440-7787
Fax
(512) 440-4059
NPI assigned
Mar 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 886680 TX Primary

Addresses

Primary practice location

1700 S Lamar Blvd
Austin, TX 78704-8962

Mailing address

1700 S Lamar Blvd
Austin, TX 78704-8962
Phone (512) 445-7787

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
886680TXMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1521504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521504000000",
    "number": "1427552959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 S LAMAR BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787048962",
            "telephone_number": "512-445-7787",
            "fax_number": "512-440-4059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 S LAMAR BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787048962",
            "telephone_number": "512-440-7787",
            "fax_number": "512-440-4059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCICERO",
        "first_name": "ODESSA",
        "middle_name": "MARIE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-20",
        "last_updated": "2018-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "886680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 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.