NPIMap

Individual provider Active NPI

Lori Ann O'Dell, RPH

  • Pharmacist
  • Twin Falls, ID
National Provider Identifier
1013147560
Registry record updated Dec 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
P4599 Issued in ID
Practice address
306 Blue Lakes Blvd N
Twin Falls, ID 83301
Phone
(208) 734-4053
NPI assigned
Jul 18, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X P4599 ID Primary

Addresses

Primary practice location

306 Blue Lakes Blvd N
Twin Falls, ID 83301

Mailing address

2404 Jorden LN Space #6
Filer, ID 83328
Phone (208) 850-2666

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
P4599IDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Walgreen Co Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1247875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262131200000",
    "number": "1013147560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2404 JORDEN LN SPACE #6",
            "city": "FILER",
            "state": "ID",
            "postal_code": "83328",
            "telephone_number": "208-850-2666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 BLUE LAKES BLVD N",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "83301",
            "telephone_number": "208-734-4053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DELL",
        "first_name": "LORI",
        "middle_name": "ANN",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-18",
        "last_updated": "2009-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P4599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.

Verify at the official NPI Registry.