Odyssey Medical Associates LLC

Primary specialty

Recovery Care Clinic/CenterTaxonomy code 261QR0800X

Legal business name

ODYSSEY MEDICAL ASSOCIATES LLC

Practice address

375 Westgate Dr
Brockton, MA 02301-1818

Phone

(857) 544-2776

NPI assigned

Apr 25, 2024

Last updated

Apr 25, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Xavier Caban

Title

President

Phone

(857) 544-2776

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1714003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714003200000",
    "number": "1659127256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 WESTGATE DR # 1133",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011855",
            "telephone_number": "857-544-2776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 WESTGATE DR",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011818",
            "telephone_number": "857-544-2776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ODYSSEY MEDICAL ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-25",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A",
        "authorized_official_last_name": "CABAN",
        "authorized_official_first_name": "XAVIER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "857-544-2776"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Recovery Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aengus Oconghaile, MB BCH BAO
• Omorovbiye T Odigie, PA
• Toyin Odogun
• Eileen M Odonnell, CRNA
• Christiana Odunze, NURSE PRACTITIONER
• Thomas Ikechukwu Ogbu, NP-C
• Chioma Adaku Ogunedo, NP
• Steven H Oh, MD
• Cajetan Anayo Ohaya, PROVIDER
• Theresa Ann Ohrenberger, BSN

• Recovery Care Clinic/Center in Brockton, MA
• Providers in Brockton, MA by specialty
• Recovery Care Clinic/Center in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; 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.