Mark Barnard Odaniel, DO

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

9700116 Issued in NC

Practice address

201 North Winstead
Suite a
Rocky Mount, NC 27804-2422

Phone

(252) 937-8222

Fax

(252) 937-6622

NPI assigned

Sep 19, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Psychiatry

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Waynesboro Family ClinicGroup PAC ID 3274445903, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

Practice roles

Locations

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.

• Waynesboro Family Clinic

  • Mental Health Counselor
  • Goldsboro, NC
  • NPI 1760417570
  Medicare reassignment Care Compare group NPD
• Dream Provider Care Services

  • Mental Health Counselor
  • Washington, NC
  • NPI 1912952672
  Medicare reassignment NPD
• Le Chris Adult Day Care of Rocky Mount, Inc.

  • Counselor
  • Rocky Mount, NC
  • NPI 1477788560

  Psychiatry

  NPD (past)
• Wayne Cares Inc.

  • Voluntary or Charitable Agency
  • Goldsboro, NC
  • NPI 1518414465
  NPD (past)
• Wellsprings Center of Goldsboro,P.a.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Goldsboro, NC
  • NPI 1023096088
  NPD (past)

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

{
    "created_epoch": "1158624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308528000000",
    "number": "1164529640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 NORTH WINSTEAD",
            "address_2": "SUITE A",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278042422",
            "telephone_number": "252-937-8222",
            "fax_number": "252-937-6622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 NORTH WINSTEAD",
            "address_2": "SUITE A",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278042422",
            "telephone_number": "252-937-8222",
            "fax_number": "252-937-6622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODANIEL",
        "first_name": "MARK",
        "middle_name": "BARNARD",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-19",
        "last_updated": "2011-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "9700116",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "9700116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5903560",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5903546",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NUMBER",
            "identifier": "135V6",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89135V6",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Oakwood Pharmacy Inc
• Oakwood Pharmacy Inc
• Oasis Home Care Services, Inc.
• Oasis II Home Care Services Inc.
• October Road Inc.
• Nathlyn Ohree, SLP
• Philip Gomba Oji, PHARMD
• Old Mill Family Care
• Old Mill Family Care
• Keith Oliver, PHARMD

• Psychiatry Physician in Rocky Mount, NC
• Providers in Rocky Mount, NC by specialty
• Psychiatry Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2011; 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.