Active NPI
Petrie Odetta Rice
- Licensed Practical Nurse
- Sylmar, CA
National Provider Identifier
1497044051
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Sep 20, 2022.
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- VN167990
- Practice address
- 14152 Foothill Blvd.
#3
Sylmar, CA 91342 - Phone
- (818) 367-9235
- NPI assigned
- Apr 5, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | VN167990 | CA | Primary |
Addresses
Primary practice location
14152 Foothill Blvd.
#3
Sylmar, CA 91342
Mailing address
14152 Foothill Blvd
#3
Sylmar, CA 91342-8000
Phone (818) 367-9235
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| VN167990 | CA | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1301961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1301961600000",
"number": "1497044051",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14152 FOOTHILL BLVD",
"address_2": "#3",
"city": "SYLMAR",
"state": "CA",
"postal_code": "913428000",
"telephone_number": "818-367-9235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14152 FOOTHILL BLVD.",
"address_2": "#3",
"city": "SYLMAR",
"state": "CA",
"postal_code": "91342",
"telephone_number": "818-367-9235"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICE",
"first_name": "PETRIE",
"middle_name": "ODETTA",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-05",
"last_updated": "2011-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "CA",
"license": "VN167990",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sylmar, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.