Individual provider Active NPI

Lucky Osawonuyi

  • Licensed Practical Nurse
  • Bridgewater, MA
National Provider Identifier
1730006206
Registry record updated Jul 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LN1003981 Issued in MA
Practice address
175 Prattown LN
Bridgewater, MA 02324-1136
Phone
(857) 221-2703
NPI assigned
Jul 3, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LN1003981 MA Primary

Addresses

Primary practice location

175 Prattown LN
Bridgewater, MA 02324-1136

Mailing address

175 Prattown LN
Bridgewater, MA 02324-1136
Phone (857) 221-2703

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

NPI Registry JSON

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

{
    "created_epoch": "1783036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783036800000",
    "number": "1730006206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 PRATTOWN LN",
            "city": "BRIDGEWATER",
            "state": "MA",
            "postal_code": "023241136",
            "telephone_number": "857-221-2703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 PRATTOWN LN",
            "city": "BRIDGEWATER",
            "state": "MA",
            "postal_code": "023241136",
            "telephone_number": "857-221-2703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSAWONUYI",
        "first_name": "LUCKY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-07-03",
        "last_updated": "2026-07-03",
        "certification_date": "2026-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MA",
            "license": "LN1003981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgewater, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2026; 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.