Active NPI
Susan H Odell, OTR
- Community Health Worker
- Plattsburgh, NY
National Provider Identifier
1841430543
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- 005380-1
- Practice address
- 151 Stafford Dr
Plattsburgh, NY 12901-5333 - Phone
- (518) 907-4326
- NPI assigned
- Feb 20, 2009
- Last updated
- Feb 20, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | 005380-1 | NY | Primary |
Addresses
Primary practice location
151 Stafford Dr
Plattsburgh, NY 12901-5333
Mailing address
151 Stafford Dr
Plattsburgh, NY 12901-5333
Phone (518) 907-4326
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 005380-1 | NY | MD | Community Health Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1235088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1235088000000",
"number": "1841430543",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "151 STAFFORD DR",
"city": "PLATTSBURGH",
"state": "NY",
"postal_code": "129015333",
"telephone_number": "518-907-4326"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "151 STAFFORD DR",
"city": "PLATTSBURGH",
"state": "NY",
"postal_code": "129015333",
"telephone_number": "518-907-4326"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ODELL",
"first_name": "SUSAN",
"middle_name": "H",
"name_prefix": "Ms.",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-02-20",
"last_updated": "2009-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "NY",
"license": "005380-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plattsburgh, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.