NPIMap

Organization Active NPI

Dr. Mark O'Daniel & Associates, P.a.

  • Psychiatry Physician
  • Rocky Mount, NC
National Provider Identifier
1427256494
Registry record updated Feb 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
9700116 Issued in NC
Legal business name
DR. MARK O'DANIEL & ASSOCIATES, P.A.
Practice address
3031 Zebulon Rd
Rocky Mount, NC 27804-2422
Phone
(252) 937-8222
Fax
(252) 937-6622
NPI assigned
Jul 11, 2007
Last updated
Feb 11, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2008

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

Authorized official

Name
Mark Barnard O'Daniel, D.O.NPI 1164529640
Title
Owner
Phone
(252) 937-8222

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 9700116 NC Primary

Addresses

Primary practice location

3031 Zebulon Rd
Rocky Mount, NC 27804-2422

Mailing address

3031 Zebulon Rd
Rocky Mount, NC 27804-2422
Phone (252) 937-8222

Other identifiers 6

IdentifierTypeStateIssuer
135V6OtherNCBLUE CROSS BLUE SHIELD
5903560MedicaidNC
6006055MedicaidNC
018TJOtherNCBLUE CROSS BLUE SHIELD
5903546MedicaidNC
89135V6MedicaidNC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1184112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202688000000",
    "number": "1427256494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3031 ZEBULON RD",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278042422",
            "telephone_number": "252-937-8222",
            "fax_number": "252-937-6622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3031 ZEBULON RD",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278042422",
            "telephone_number": "252-937-8222",
            "fax_number": "252-937-6622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. MARK O'DANIEL & ASSOCIATES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-11",
        "last_updated": "2008-02-11",
        "status": "A",
        "authorized_official_last_name": "O'DANIEL",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "BARNARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-937-8222",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "9700116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "135V6",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5903560",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6006055",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "018TJ",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5903546",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89135V6",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Mount, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2008; 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.