T. Gerald O'Daniel M.D., PLLC

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

24070 Issued in KY

Legal business name

T. GERALD O'DANIEL M.D., PLLC

Practice address

222 S 1St St
Suite 100
Louisville, KY 40202-1350

Phone

(502) 584-1109

Fax

(502) 589-6882

NPI assigned

Jan 31, 2007

Organization subpart

No

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

Authorized official

Name

Dr. T. Gerald O'Daniel, M.D., PLLC

Title

Sole Proprietor

Phone

(502) 584-1109

Specialties & licenses 1

Addresses

Other identifiers 8

Locations

Practitioners 2

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.

• Mark E. Chariker, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Louisville, KY
  • NPI 1194724997
  NPD (past)
• Scott Joseph Rapp, M.D.

  • Plastic Surgery Physician
  • Cincinnati, OH
  • NPI 1346402948

  Plastic and Reconstructive Surgery

  NPD (past)

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288224000000",
    "number": "1457498107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 S 1ST ST",
            "address_2": "SUITE 100",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021350",
            "telephone_number": "502-584-1109",
            "fax_number": "502-589-6882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 S 1ST ST",
            "address_2": "SUITE 100",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021350",
            "telephone_number": "502-584-1109",
            "fax_number": "502-589-6882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "T. GERALD O'DANIEL M.D., PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2010-10-28",
        "status": "A",
        "authorized_official_last_name": "O'DANIEL",
        "authorized_official_first_name": "T.",
        "authorized_official_middle_name": "GERALD",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "502-584-1109",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D., PLLC"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "KY",
            "license": "24070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "KY1118",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT PIN",
            "identifier": "1058697",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN",
            "identifier": "000000219660",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "002",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100033340A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "667357",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64240708",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "KY0057799",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Synergy Rehabilitation
• Synergy Rehabilitation, Inc.
• Syntricity Rehab Solutions of Ky, LLC. (Syntricity Rehab Solutions of KY)
• Robin Carmelle Szczapinski, MSN,ARNP,BC
• Christine Nicole Szesny, PT, DPT
• Cheyla Tabares Cuesta
• Bita Tabassi, OD
• Tabitha International Foundation (Tabitha Foundation)
• Tabitha International Foundation Corporation
• Tabler Clinical Services, PSC

• Plastic and Reconstructive Surgery Physician in Louisville, KY
• Providers in Louisville, KY by specialty
• Plastic and Reconstructive Surgery Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2010; 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.