Individual provider Active NPI

Ruth Florence Oduor

  • Adult Psychiatric/Mental Health Registered Nurse
  • Lynn, MA
National Provider Identifier
1700456449
Registry record updated Jun 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X
License
RN2258864 Issued in MA
Practice address
269 Union St
Lynn, MA 01901-1314
Phone
(781) 581-3900
NPI assigned
Jun 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X RN2258864 MA Primary

Addresses

Primary practice location

269 Union St
Lynn, MA 01901-1314

Mailing address

28 Yorkshire Drive Ext
Tewksbury, MA 01876-2268
Phone (617) 281-0406

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20211019001423 MA Practitioner - Nurse Practitioner 9830587153 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lynn Community Health, Inc.Group PAC ID 0042217507, 95 clinicians

Practice addresses (Care Compare)

20 Central Ave
Lynn, MA 01901-1314

269 Union St
Lynn, MA 01901-1314
Phone (959) 216-7305

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lynn Community Health, Inc. CurrentSince Oct 6, 2021 Accepting new patients
Supportive Behavioral Care of Ma LLC CurrentSince Jan 1, 2026 Accepting new patients

Locations

44 School St
Rm 325
Boston, MA 02108
Phone (508) 831-8558

280 Union St
Ste 202
Lynn, MA 01901
Phone (781) 780-4555

269 Union St
Lynn, MA 01901
Phone (781) 581-9832

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

Interoperability endpoints

  • Direct secure messaging: roduor366534@direct.ochin.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1624579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624579200000",
    "number": "1700456449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 YORKSHIRE DRIVE EXT",
            "city": "TEWKSBURY",
            "state": "MA",
            "postal_code": "018762268",
            "telephone_number": "617-281-0406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "269 UNION ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019011314",
            "telephone_number": "781-581-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODUOR",
        "first_name": "RUTH",
        "middle_name": "FLORENCE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-25",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "MA",
            "license": "RN2258864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynn, MA

Sources for this page

Verify at the official NPI Registry.