Mary Anne E Odaniel, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

007430 Issued in KY

Practice address

444 S Main St
Madisonville, KY 42431

Phone

(270) 825-0069

Fax

(270) 824-9777

NPI assigned

May 9, 2018

Last updated

Mar 6, 2019By 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 3

Addresses

Other identifiers 1

Other names 1

• Mary Anne E Johnson Former name

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Owensboro Health Medical Group IncGroup PAC ID 0648255034, 455 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Owensboro Health Medical Group Inc

  dba Owensboro Health Muhlenberg Community Hospital Wound Center

  • Surgery Physician
  • Greenville, KY
  • NPI 1235518242
  Medicare reassignment Care Compare group NPD
• Owensboro Health Medical Group Inc

  dba Owensboro Health Medical Group Premier Primary Care

  • Internal Medicine Physician
  • Owensboro, KY
  • NPI 1306700711
  NPD
• Owensboro Health Medical Group, Inc

  dba Owensboro Heatlh Medical Group Ear Nose and Throat - Owensboro

  • Otolaryngology Physician
  • Owensboro, KY
  • NPI 1558779009
  NPD
• Owensboro Health Medical Group, Inc

  dba Owensboro Health Medical Group - EKG Professional Services

  • Family Medicine Physician
  • Owensboro, KY
  • NPI 1376594242

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1525824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551830400000",
    "number": "1578052171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23229",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423043229",
            "telephone_number": "270-688-1330",
            "fax_number": "270-688-1338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 S MAIN ST",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "42431",
            "telephone_number": "270-825-0069",
            "fax_number": "270-824-9777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODANIEL",
        "first_name": "MARY ANNE",
        "middle_name": "E",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-09",
        "last_updated": "2019-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "007430",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "TP2018037",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100552180",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY ANNE",
            "last_name": "JOHNSON",
            "middle_name": "E",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• North Star Counseling Services, LLC
• Amanda Margaret O'Donnell, MS-SLP, CCC
• William Stephen O'Hearn III, MD
• Ardith Elaine O'Rourke, MSN, NP-C
• Chastity Oakley
• Joshua Odom, PHARMD
• Ohearn Medical, PLLC
• Ohio Valley Neurology LLC
• Heather Pendergraff Oldham, PHARMD
• Omni Visions, Inc

• Physical Therapist in Madisonville, KY
• Providers in Madisonville, KY by specialty
• Physical Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.