Chioma Nnenna Odurukwe

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

9712 Issued in MN

Practice address

251 Woodlake Dr SE
Rochester, MN 55904-5530

Phone

(507) 206-2561

NPI assigned

Dec 19, 2022

Sex

Female

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

Enrolled in MN

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

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.

• Community Behavioral Health Hospital-Rochester

  • Psychiatric Hospital
  • Rochester, MN
  • NPI 1669418851
  Medicare reassignment NPD

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

{
    "created_epoch": "1671408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1780396168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 WOODLAKE DR SE",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559045530",
            "telephone_number": "507-206-2561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 WOODLAKE DR SE",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559045530",
            "telephone_number": "507-206-2561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODURUKWE",
        "first_name": "CHIOMA",
        "middle_name": "NNENNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-19",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "9712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Kyle Odorico, MD
• Mary-Tiffany Adannia Oduah, MD
• Adekunle Odubeko, CRNA
• Kehinde Adeseye Odubeko, CRNA
• Oladayo Odubeko, DPT
• Odyssey Healthcare Holding Company
• Richard A Oeckler, M.D., PHD
• Rebecca Jo Oelslager
• Brady William Oeltjenbruns, APRN-CNP
• Amanda Oestreich

• Family Nurse Practitioner in Rochester, MN
• Providers in Rochester, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; 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.