Active NPI
Robert Scott Odewald, PA-C, PHARM.D.
- Physician Assistant
- Virginia Beach, VA
National Provider Identifier
1073592457
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 332 Newtown Rd
Virginia Beach, VA 23462-1793 - Phone
- (757) 473-8400
- Fax
- (757) 473-0712
- NPI assigned
- Jan 12, 2006
- Last updated
- Oct 23, 2012
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
332 Newtown Rd
Virginia Beach, VA 23462-1793
Mailing address
PO Box 758963
Baltimore, MD 21275-8963
Phone (804) 968-5700
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)
- Enrolled
- Credentials
- Physician Assistant, Doctor of Pharmacy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350950400000",
"number": "1073592457",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 758963",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212758963",
"telephone_number": "804-968-5700",
"fax_number": "804-217-7991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "332 NEWTOWN RD",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234621793",
"telephone_number": "757-473-8400",
"fax_number": "757-473-0712"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ODEWALD",
"first_name": "ROBERT",
"middle_name": "SCOTT",
"name_prefix": "Mr.",
"credential": "PA-C, PHARM.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-12",
"last_updated": "2012-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Virginia Beach, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.