Evans Odhiambo

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

11843 Issued in MN

Practice address

8056 James Ave N
Brooklyn Park, MN 55444-1673

Phone

(201) 214-9999

NPI assigned

Sep 30, 2024

Sex

Male

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Integrated Wound Care Minnesota PLLCGroup PAC ID 2769722511, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: evans.odhiambo@811393367080964.direct.elationemr.com

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.

• Integrated Wound Care Minnesota PLLC

  • General Practice Physician
  • Delano, MN
  • NPI 1205390457
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1727654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1992523898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8056 JAMES AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554441673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8056 JAMES AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554441673",
            "telephone_number": "201-214-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODHIAMBO",
        "first_name": "EVANS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-30",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "11843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oak Crest Ventures LLC
• Oasis Home Health, LLC
• Oasis Homecare Services L.L.C
• Andrew Ireyi Obami
• Marie Lynn Odegaard, LPCC
• Emily Oeri
• Christopher Ebalu Ogharibhor
• Enite E Oghenekaro
• Adenike S Ogunbanwo, RN
• Jonathan Ohman, PHARMD

• Nurse Practitioner in Brooklyn Park, MN
• Providers in Brooklyn Park, MN by specialty
• Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.