NPIMap

Individual provider Active NPI

Innocent N. Odocha, MD

  • Family Medicine Physician
  • Gainesville, FL
National Provider Identifier
1568560829
Registry record updated Jul 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME86683 Issued in FL
Practice address
605 NE 1St St
Gainesville, FL 32601-3339
Phone
(352) 371-3212
Fax
(352) 371-3213
NPI assigned
Sep 20, 2006
Last updated
Jul 21, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME86683 FL Primary

Addresses

Primary practice location

605 NE 1St St
Gainesville, FL 32601-3339

Mailing address

605 NE 1St St
Gainesville, FL 32601-3339
Phone (352) 371-3212

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100323000136 FL Practitioner - Family Practice 6406981943 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wright State University Boonshoft School of Medicine, 2000
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Innocent Odocha MD PAGroup PAC ID 6204961741, 4 clinicians
Lake Area Physical Therapy Inc.Group PAC ID 3678604840, 372 clinicians

Practice addresses (Care Compare)

605 NE 1St St
Gainesville, FL 32601-3339
Phone (352) 371-3212

PO Box
Suite 1099
Melrose, FL 32666-1099

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Innocent Odocha, M.D.,P.a. Family Medicine Current Accepting new patients
Innocent Odocha MD PA CurrentSince Jul 16, 2009 Accepting new patients

Locations

605 NE 1st St
Gainesville, FL 32601
Phone (352) 334-0955

816 NW 13th St
Gainesville, FL 32601
Phone (352) 273-5144

Organizations & group practices 3

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469059200000",
    "number": "1568560829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 NE 1ST ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326013339",
            "telephone_number": "352-371-3212",
            "fax_number": "352-371-3213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 NE 1ST ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326013339",
            "telephone_number": "352-371-3212",
            "fax_number": "352-371-3213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODOCHA",
        "first_name": "INNOCENT",
        "middle_name": "N.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2016-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME86683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.