Individual provider Active NPI

Charles Odonnell, DO

  • Emergency Medicine Physician
  • Salina, KS
National Provider Identifier
1386600385
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
05-25870 Issued in KS
Practice address
400 S Santa Fe Ave
Salina, KS 67401-4144
Phone
(785) 452-7000
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 05-25870 KS Primary

Addresses

Primary practice location

400 S Santa Fe Ave
Salina, KS 67401-4144

Mailing address

6896 W Snowville Rd
Brecksville, OH 44141-3214

Other identifiers 2

IdentifierTypeStateIssuer
627642OtherKSFIRST GUARD
100975OtherKSBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20040202000343 KS Practitioner - Emergency Medicine 6204739600 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
05-25870KSMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carepoint Emergency Medicine Kansas LLC Emergency Medicine CurrentSince Dec 5, 2016 Accepting new patients
Emergency Physicians of Salina, LLC Emergency Medicine Past Accepting new patients
Runway Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Ssa Salina, Inc. Emergency Medicine Past Accepting new patients
Emergency Services, PA Emergency Medicine Past Accepting new patients

Locations

221 W US Highway 54
Andover, KS 67002
Phone (316) 962-5100

2648 N Rock Rd
Derby, KS 67037
Phone (316) 962-2000

8714 W 13th St N
Wichita, KS 67212
Phone (316) 962-9900

550 N Hillside St
Wichita, KS 67214
Phone (316) 688-2239

2610 N Woodlawn Blvd
Wichita, KS 67220
Phone (316) 684-3838

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386600385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6896 W SNOWVILLE RD",
            "city": "BRECKSVILLE",
            "state": "OH",
            "postal_code": "441413214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S SANTA FE AVE",
            "city": "SALINA",
            "state": "KS",
            "postal_code": "674014144",
            "telephone_number": "785-452-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODONNELL",
        "first_name": "CHARLES",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KS",
            "license": "05-25870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST GUARD",
            "identifier": "627642",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "100975",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salina, KS

Sources for this page

Verify at the official NPI Registry.