Active NPI
Michael D. Odgren, RPA, RT(R)(CT)
- Radiology Practitioner Assistant
- Denver, CO
National Provider Identifier
1407983356
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiology Practitioner Assistant
- Practice address
- 938 Bannock St
Ste 300
Denver, CO 80204-4028 - Phone
- (303) 914-8800
- NPI assigned
- Feb 27, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiologic Technologist | 247100000X | |||
| Radiology Practitioner Assistant | 243U00000X | Primary | ||
| Computed Tomography Radiologic Technologist | 2471C3401X |
Addresses
Primary practice location
938 Bannock St
Ste 300
Denver, CO 80204-4028
Mailing address
938 Bannock St
Ste 300
Denver, CO 80204-4028
Phone (303) 914-8800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04004826 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1259884800000",
"number": "1407983356",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "938 BANNOCK ST",
"address_2": "STE 300",
"city": "DENVER",
"state": "CO",
"postal_code": "802044028",
"telephone_number": "303-914-8800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "938 BANNOCK ST",
"address_2": "STE 300",
"city": "DENVER",
"state": "CO",
"postal_code": "802044028",
"telephone_number": "303-914-8800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ODGREN",
"first_name": "MICHAEL",
"middle_name": "D.",
"credential": "RPA, RT(R)(CT)",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-27",
"last_updated": "2009-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "247100000X",
"taxonomy_group": "",
"desc": "Radiologic Technologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "243U00000X",
"taxonomy_group": "",
"desc": "Radiology Practitioner Assistant",
"state": null,
"license": null,
"primary": true
},
{
"code": "2471C3401X",
"taxonomy_group": "",
"desc": "Radiologic Technologist, Computed Tomography",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "04004826",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.