Active NPI
David J. Odland, MD
- Emergency Medicine Physician
- Alexandria, MN
National Provider Identifier
1497728836
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 27571
- Practice address
- 1527 Broadway St
Alexandria, MN 56308-2537 - Phone
- (320) 762-0399
- NPI assigned
- Feb 8, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 27571 | MN | Primary |
Addresses
Primary practice location
1527 Broadway St
Alexandria, MN 56308-2537
Mailing address
607 Prospect Cir
Marshall, MN 56258-2074
Phone (507) 532-7553
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 745372800 | Medicaid | MN | |
| P00415252 | Other | MN | RR MEDICARE |
| HP33756 | Other | MN | HEALTHPARTNERS |
| 447K4OD | Other | MN | BC/BS |
| 080016069 | Other | MN | MET |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27571 | MN | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212451200000",
"number": "1497728836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "607 PROSPECT CIR",
"city": "MARSHALL",
"state": "MN",
"postal_code": "562582074",
"telephone_number": "507-532-7553"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1527 BROADWAY ST",
"city": "ALEXANDRIA",
"state": "MN",
"postal_code": "563082537",
"telephone_number": "320-762-0399"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ODLAND",
"first_name": "DAVID",
"middle_name": "J.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-08",
"last_updated": "2008-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MN",
"license": "27571",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "745372800",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00415252",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS",
"identifier": "HP33756",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "447K4OD",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MET",
"identifier": "080016069",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Alexandria, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 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.