Individual provider Active NPI

Everline Osanya, NP-C

  • Gerontology Nurse Practitioner
  • Manchester, NH
National Provider Identifier
1497138739
Registry record updated Oct 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
060199-23 Issued in NH
Practice address
138 Webster St
Manchester, NH 03104-2512
Phone
(603) 663-7030
NPI assigned
Jul 6, 2015
Last updated
Oct 8, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X RN2276640 MA
Gerontology Nurse Practitioner 363LG0600X 060199-23 NH Primary

Addresses

Primary practice location

138 Webster St
Manchester, NH 03104-2512

Mailing address

138 Webster St
Manchester, NH 03104-2512
Phone (603) 663-7030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20201001001622 NH Practitioner - Nurse Practitioner 6305144510 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elliot Physicians NetworkGroup PAC ID 6406743988, 78 clinicians

Practice addresses (Care Compare)

275 Mammoth Rd
Manchester, NH 03109-4133

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2276640MAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Elliot Physicians Network CurrentSince Aug 24, 2020 Accepting new patients

Locations

25 S River Rd
Bedford, NH 03110
Phone (603) 626-4392

138 Webster St
Manchester, NH 03104
Phone (603) 645-5977

275 Mammoth Rd
Ste 1
Manchester, NH 03109
Phone (603) 663-3222

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1436140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602115200000",
    "number": "1497138739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 WEBSTER ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031042512",
            "telephone_number": "603-663-7030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 WEBSTER ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031042512",
            "telephone_number": "603-663-7030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSANYA",
        "first_name": "EVERLINE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-06",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MA",
            "license": "RN2276640",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NH",
            "license": "060199-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.