Chinedu Uzoma Odurukwe

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

6989 Issued in MN

Practice address

3301 7TH Ave
Anoka, MN 55303-4516

Phone

(651) 431-5000

NPI assigned

Nov 13, 2019

Sex

Male

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

State licenses

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.

• Anoka Metro Regional Treatment Center

  • Psychiatric Hospital
  • Anoka, MN
  • NPI 1275585564
  NPD
• Nystrom & Associates, LTD

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188
  NPD

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

{
    "created_epoch": "1573603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602460800000",
    "number": "1619512621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 7TH AVE UNIT B",
            "city": "ANOKA",
            "state": "MN",
            "postal_code": "553034516",
            "telephone_number": "651-431-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 7TH AVE",
            "city": "ANOKA",
            "state": "MN",
            "postal_code": "553034516",
            "telephone_number": "651-431-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1900 Silver Lake Rd NW Ste 110",
            "address_purpose": "LOCATION",
            "city": "New Brighton",
            "state": "MN",
            "postal_code": "551121789",
            "country_code": "US",
            "telephone_number": "651-628-9566",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ODURUKWE",
        "first_name": "CHINEDU",
        "middle_name": "UZOMA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-13",
        "last_updated": "2020-10-12",
        "certification_date": "2020-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "6989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Naomi Nystrom, PSYD, LP
• Hailey O'Como, CCC-SLP
• Sean O'Dell, DDS, MS
• Samantha Rae O'Donnell
• Linda Oberg, LMFT
• Nicole Olesen
• Emily Ongaga
• Sara Elisabeth Opitz
• Optimal Home Service Professional Corporation
• Optiovillage, Inc

• Psychiatric/Mental Health Nurse Practitioner in Anoka, MN
• Providers in Anoka, MN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2020; 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.