Individual provider Active NPI

Steven John Odonnell, RRT,RPFT

  • Critical Care Registered Respiratory Therapist
  • West Roxbury, MA
National Provider Identifier
1952978447
Registry record updated Jun 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Registered Respiratory TherapistTaxonomy code 2279C0205X
License
RT1173 Issued in MA
Practice address
1400 VFW Pkwy
West Roxbury, MA 02132
Phone
(857) 203-6442
NPI assigned
Jun 4, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Registered Respiratory Therapist 2279C0205X RT1173 MA Primary

Addresses

Primary practice location

1400 VFW Pkwy
West Roxbury, MA 02132

Mailing address

24 Greenbriar Road
Brockton, MA 02301
Phone (508) 587-7783

Other identifiers 1

IdentifierTypeStateIssuer
RT1173OtherMACOMMONWEALTH OF MASSACHUSETTS RESPIRATORY THERAPY

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

LicenseStateTypeSpecialty
RT1173MAMDCritical Care Registered Respiratory Therapist

NPI Registry JSON

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

{
    "created_epoch": "1622764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622764800000",
    "number": "1952978447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 GREENBRIAR ROAD",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "02301",
            "telephone_number": "508-587-7783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 VFW PKWY",
            "city": "WEST ROXBURY",
            "state": "MA",
            "postal_code": "02132",
            "telephone_number": "857-203-6442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODONNELL",
        "first_name": "STEVEN",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "RRT,RPFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-04",
        "last_updated": "2021-06-04",
        "certification_date": "2021-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2279C0205X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered, Critical Care",
            "state": "MA",
            "license": "RT1173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMONWEALTH OF MASSACHUSETTS RESPIRATORY THERAPY",
            "identifier": "RT1173",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Roxbury, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2021; 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.