Erica L. O'Donnell Dopa

Primary specialty

Adolescent Medicine (Family Medicine) PhysicianTaxonomy code 207QA0000X

License

OS7905 Issued in FL

Legal business name

ERICA L. O'DONNELL DOPA

Practice address

1400 Hand Ave
Suite K
Ormond Beach, FL 32174-8194

Phone

(386) 673-0517

Fax

(386) 671-6458

NPI assigned

Aug 16, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Erica Lynne O'Donnell, D.O.NPI 1407887029

Title

President

Phone

(386) 673-0517

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Erica Lynne O'Donnell, D.O.

  • Family Medicine Physician
  • Ormond Beach, FL
  • NPI 1407887029
  NPD (past) Authorized official

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1144333105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 HAND AVE",
            "address_2": "SUITE K",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321748194",
            "telephone_number": "386-673-0517",
            "fax_number": "386-671-6458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 HAND AVE",
            "address_2": "SUITE K",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321748194",
            "telephone_number": "386-673-0517",
            "fax_number": "386-671-6458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERICA L. O'DONNELL DOPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "O'DONNELL",
        "authorized_official_first_name": "ERICA",
        "authorized_official_middle_name": "LYNNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-673-0517",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207QA0000X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": "FL",
            "license": "OS7905",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "01768",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE RAILROAD",
            "identifier": "80184473",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7512263",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Adolescent Medicine (Family Medicine) Physician in Ormond Beach, FL
• Providers in Ormond Beach, FL by specialty
• Adolescent Medicine (Family Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.