Active NPI
Ann E Odonnell, D.O.
- Internal Medicine Physician
- Davenport, IA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 03020
- Practice address
- 1820 W 3Rd St
Davenport, IA 52802-1812 - Phone
- (563) 326-1661
- Fax
- (563) 326-1901
- NPI assigned
- Jan 10, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 03020 | IA | Primary |
Addresses
Primary practice location
1820 W 3Rd St
Davenport, IA 52802-1812
Mailing address
1820 W 3Rd St
Davenport, IA 52802-1812
Phone (563) 326-1661
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5163295 | Medicaid | IA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ann.odonnell@direct.genesishealth.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100717000184 | IA | Practitioner - Internal Medicine | 0244281335 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03020 | IA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Genesis Health System | Current | Accepting new patients | |
| Davenport Clinic, P.C. | Current | Accepting new patients | |
| Genesis Health System | Internal Medicine | Current | Accepting new patients |
Locations
2546 Tech Dr
Bettendorf, IA 52722
Phone (563) 421-5400
865 Lincoln Rd
Ste 100
Bettendorf, IA 52722
Phone (563) 355-1000
4700 E 56th St
Ste 100
Davenport, IA 52807
Phone (563) 383-2667
1351 W Central Park Ave
Ste 340
Davenport, IA 52804
Phone (563) 421-1287
1820 W 3rd St
Davenport, IA 52802
Phone (563) 326-1661
Interoperability endpoints
- ann.odonnell@direct.genesishealth.com
Organizations & group practices 3
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.
-
- Primary Care Clinic/Center
- Davenport, IA
- NPI 1235118118
-
- General Acute Care Hospital
- Silvis, IL
- NPI 1427132604
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622592000000",
"number": "1376522243",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1820 W 3RD ST",
"city": "DAVENPORT",
"state": "IA",
"postal_code": "528021812",
"telephone_number": "563-326-1661",
"fax_number": "563-326-1901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1820 W 3RD ST",
"city": "DAVENPORT",
"state": "IA",
"postal_code": "528021812",
"telephone_number": "563-326-1661",
"fax_number": "563-326-1901"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ODONNELL",
"first_name": "ANN",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-01-10",
"last_updated": "2021-06-02",
"certification_date": "2021-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IA",
"license": "03020",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5163295",
"state": "IA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ann.odonnell@direct.genesishealth.com",
"affiliation": "N",
"endpointDescription": "Genesis Health System Direct Email Address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCDA",
"address_1": "2546 Tech Dr",
"city": "Bettendorf",
"state": "IA",
"country_code": "US",
"postal_code": "527223345",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Davenport, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; 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.