Organization Active NPI

Robert Odell MD PHD Medical Enterprises

  • Pain Medicine (Anesthesiology) Physician
  • Las Vegas, NV
National Provider Identifier
1306124086
Registry record updated Feb 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
ROBERT ODELL MD PHD MEDICAL ENTERPRISES
Practice address
8084 W Sahara Ave
Suite E
Las Vegas, NV 89117-2073
Phone
(702) 257-7246
Fax
(702) 254-7044
NPI assigned
Jul 28, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2012

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

Authorized official

Name
Dr. Robert H Odell Jr., MDNPI 1013957026
Title
Owner
Phone
(702) 257-7246

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X Primary
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X

Addresses

Primary practice location

8084 W Sahara Ave
Suite E
Las Vegas, NV 89117-2073

Mailing address

3540 W Sahara Ave
368
Las Vegas, NV 89102-5816
Phone (702) 257-7246

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110713000241 NV Part B Supplier - Clinic/Group Practice 2062680325 Receives reassigned benefits from 5 practitioners
Practice locations: Henderson, NV; Las Vegas, NV

National Provider Directory

National Provider Directory

Locations

8915 S Pecos Rd
Ste 18B
Henderson, NV 89074
Phone (702) 799-9014

2557 Wigwam Pkwy
Henderson, NV 89074
Phone (702) 212-6357

3540 W Sahara Ave
#368
Las Vegas, NV 89102

2280 E Calvada Blvd
Ste 201
Pahrump, NV 89048
Phone (702) 257-7246

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1311811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329436800000",
    "number": "1306124086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3540 W SAHARA AVE",
            "address_2": "368",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891025816",
            "telephone_number": "702-257-7246",
            "fax_number": "702-254-7044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8084 W SAHARA AVE",
            "address_2": "SUITE E",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891172073",
            "telephone_number": "702-257-7246",
            "fax_number": "702-254-7044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT ODELL MD PHD MEDICAL ENTERPRISES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-28",
        "last_updated": "2012-02-17",
        "status": "A",
        "authorized_official_last_name": "ODELL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-257-7246",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.