Kenneth O'Dell, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME139615 Issued in FL

Practice address

1115 W Call St
Tallahassee, FL 32306-3556

Phone

(850) 644-1855

NPI assigned

May 22, 2016

Sex

Male

Sole proprietor

Yes

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 FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/HHFDAA

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.

• Florida Medical Practice Plan Inc

  • General Practice Physician
  • Tallahassee, FL
  • NPI 1326386293

  Single Specialty

  Medicare reassignment NPD
• Maxwell Medical PLLC

  • Family Medicine Physician
  • Sebring, FL
  • NPI 1366638454

  Single Specialty

  Medicare reassignment NPD
• Lima Memorial Joint Operating Company

  dba Lima Memorial Health System

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1463875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673568000000",
    "number": "1154778975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 W CALL ST",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323063556",
            "telephone_number": "850-644-1855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 W CALL ST",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323063556",
            "telephone_number": "850-644-1855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DELL",
        "first_name": "KENNETH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-22",
        "last_updated": "2023-01-13",
        "certification_date": "2023-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME139615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephany Herndon Nystrand, MT-BC
• O.M.D. Logistics, LLC
• Antoinette O'Brian
• Alicia Bowden O'Brien
• David O'Bryan, M.D.
• Kayla O'Donnell, COTA/L
• Sean O'Donnell, CAA
• Karly O'Grady
• Jaclyn Nikole Sofia O'Hara, B.S.
• Sigrid Elisabeth O'Healaigh I

• Family Medicine Physician in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.