Organization Active NPI

Lan Q. O'Donnell, O.D., P.a.

  • Optometrist
  • Santa Rosa Beach, FL
National Provider Identifier
1356438634
Registry record updated Feb 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 3968 Issued in FL
Legal business name
LAN Q. O'DONNELL, O.D., P.A.
Practice address
6757 US Highway 98 W Ste 101
Santa Rosa Beach, FL 32459-4780
Phone
(850) 622-4000
Fax
(850) 622-0072
NPI assigned
Oct 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2020

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

Authorized official

Name
Lan O'Donnell, ODNPI 1831286111
Title
President/Owner
Phone
(850) 622-4000

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPC 3968 FL Primary

Addresses

Primary practice location

6757 US Highway 98 W Ste 101
Santa Rosa Beach, FL 32459-4780

Mailing address

870 Mack Bayou Rd
Santa Rosa Beach, FL 32459-7150
Phone (850) 622-4000

Other names 1

  • O'Donnell Eye Institute Doing business as

National Provider Directory

National Provider Directory

Locations

6757 US Highway 98 W
Ste 101
Santa Rosa Beach, FL 32459
Phone (850) 202-9759

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581379200000",
    "number": "1356438634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "870 MACK BAYOU RD",
            "city": "SANTA ROSA BEACH",
            "state": "FL",
            "postal_code": "324597150",
            "telephone_number": "850-622-4000",
            "fax_number": "850-622-0072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6757 US HIGHWAY 98 W STE 101",
            "city": "SANTA ROSA BEACH",
            "state": "FL",
            "postal_code": "324594780",
            "telephone_number": "850-622-4000",
            "fax_number": "850-622-0072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAN Q. O'DONNELL, O.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A",
        "authorized_official_last_name": "O'DONNELL",
        "authorized_official_first_name": "LAN",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "850-622-4000",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 3968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "O'Donnell Eye Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Rosa Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.