NPIMap

Organization Active NPI

Odom Health and Wellness

  • Physical Therapy Clinic/Center
  • Columbia Heights, MN
National Provider Identifier
1295132454
Registry record updated Dec 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
9846 Issued in MN
Legal business name
ODOM HEALTH AND WELLNESS
Practice address
3801 Hart Blvd
Columbia Heights, MN 55421-4106
Phone
(763) 210-6697
NPI assigned
Dec 3, 2014
Last updated
Dec 3, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2014

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

Authorized official

Name
Ms. Meghan Klein, DPT
Title
Director of Clinical Development
Phone
(952) 856-4722

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 9846 MN Primary

Addresses

Primary practice location

3801 Hart Blvd
Columbia Heights, MN 55421-4106

Mailing address

3801 Hart Blvd
Columbia Heights, MN 55421-4106

National Provider Directory

National Provider Directory
Tax ID family
Odom Sports Medicine PA4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1417564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417564800000",
    "number": "1295132454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 HART BLVD",
            "city": "COLUMBIA HEIGHTS",
            "state": "MN",
            "postal_code": "554214106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 HART BLVD",
            "city": "COLUMBIA HEIGHTS",
            "state": "MN",
            "postal_code": "554214106",
            "telephone_number": "763-210-6697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ODOM HEALTH AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-03",
        "last_updated": "2014-12-03",
        "status": "A",
        "authorized_official_last_name": "KLEIN",
        "authorized_official_first_name": "MEGHAN",
        "authorized_official_title_or_position": "DIRECTOR OF CLINICAL DEVELOPMENT",
        "authorized_official_telephone_number": "952-856-4722",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MN",
            "license": "9846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia Heights, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2014; 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.