Organization Active NPI

Odyssey Health Services

  • Federally Qualified Health Center (FQHC)
  • New York, NY
National Provider Identifier
1922475235
Registry record updated Aug 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
ODYSSEY HEALTH SERVICES
Practice address
219 E 121 St
New York, NY 10035
Phone
(212) 361-1678
Fax
(212) 361-1666
NPI assigned
Aug 24, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2015

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

Authorized official

Name
Mr. Daryl Bruce Everett
Title
Controller
Phone
(212) 361-1678

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

219 E 121 St
New York, NY 10035

Mailing address

120 Wall St
17TH Floor
New York, NY 10005-3904
Phone (212) 361-1678

National Provider Directory

National Provider Directory

Locations

120 Wall St
Fl 17
New York, NY 10005
Phone (212) 361-1622

219 E 121st St
New York, NY 10035
Phone (212) 987-5100

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1440374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440374400000",
    "number": "1922475235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 WALL ST",
            "address_2": "17TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100053904",
            "telephone_number": "212-361-1678",
            "fax_number": "212-361-1666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 E 121 ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10035",
            "telephone_number": "212-361-1678",
            "fax_number": "212-361-1666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ODYSSEY HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-24",
        "last_updated": "2015-08-24",
        "status": "A",
        "authorized_official_last_name": "EVERETT",
        "authorized_official_first_name": "DARYL",
        "authorized_official_middle_name": "BRUCE",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "212-361-1678",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2015; 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.