Active NPI
Vincent Obode, SOLE PROPRIETOR
- Home Health Registered Nurse
- East Orange, NJ
National Provider Identifier
1912519125
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Registered Nurse
- License
- 26NO11868300
- Practice address
- 134 Evergreen PL Ste 604
East Orange, NJ 07018-2021 - Phone
- (862) 520-2029
- Fax
- (862) 252-6836
- NPI assigned
- Aug 19, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Home Health Registered Nurse | 163WH0200X | 26NO11868300 | NJ | Primary |
Addresses
Primary practice location
134 Evergreen PL Ste 604
East Orange, NJ 07018-2021
Mailing address
134 Evergreen PL Ste 604
East Orange, NJ 07018-2021
Phone (862) 520-2029
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 |
|---|---|---|---|
| 26NO11868300 | NJ | MD | Home Health Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Victory Health Solutions Inc. | Current | Accepting new patients |
Locations
134 Evergreen Pl
Ste 604
East Orange, NJ 07018
Phone (862) 520-2029
Organizations & group practices 1
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.
-
- Home Health Agency
- East Orange, NJ
- NPI 1548051170
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723507200000",
"number": "1912519125",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "134 EVERGREEN PL STE 604",
"city": "EAST ORANGE",
"state": "NJ",
"postal_code": "070182021",
"telephone_number": "862-520-2029",
"fax_number": "862-252-6836"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "134 EVERGREEN PL STE 604",
"city": "EAST ORANGE",
"state": "NJ",
"postal_code": "070182021",
"telephone_number": "862-520-2029",
"fax_number": "862-252-6836"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OBODE",
"first_name": "VINCENT",
"name_prefix": "Mr.",
"credential": "SOLE PROPRIETOR",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-08-19",
"last_updated": "2024-08-13",
"certification_date": "2024-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "163WH0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Home Health",
"state": "NJ",
"license": "26NO11868300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in East Orange, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.