Callie Marie Odonovan

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OC017758 Issued in PA

Practice address

12 Evergreen Dr
Jermyn, PA 18433-1130

Phone

(570) 840-8356

NPI assigned

Jun 23, 2021

Last updated

Jun 23, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Balance Pediatric Developmental Services, LLC

  • Physical Therapist
  • Jermyn, PA
  • NPI 1700037173

  Occupational Therapist

  NPD (past)

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

{
    "created_epoch": "1624406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1548839533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 EVERGREEN DR",
            "city": "JERMYN",
            "state": "PA",
            "postal_code": "184331130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 EVERGREEN DR",
            "city": "JERMYN",
            "state": "PA",
            "postal_code": "184331130",
            "telephone_number": "570-840-8356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODONOVAN",
        "first_name": "CALLIE",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-23",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "OC017758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leah Milewski
• Becky Spedding Moore, OTR/L
• Angela Murphy, CRNP
• Megan Murphy, PT
• Ivy Nataloni
• Karen Papi, MSRD,CDE,LDN
• Emily Marie Pavlowski, DMD
• Sarah Pettinato
• Erin Platts
• Samuel Michael Prisco, DDS

• Occupational Therapist in Jermyn, PA
• Providers in Jermyn, PA by specialty
• Occupational Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; 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.