NPIMap

Individual provider Active NPI

Odianosen Eigbire-Molen, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Little Rock, AR
National Provider Identifier
1578096533
Registry record updated Aug 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
E-15116 Issued in AR
Practice address
10810 Executive Center Dr Ste 100
Little Rock, AR 72211-4386
Phone
(501) 604-2695
Fax
(501) 604-2699
NPI assigned
Apr 6, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 999999
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X E-15116 AR Primary

Addresses

Primary practice location

10810 Executive Center Dr Ste 100
Little Rock, AR 72211-4386

Mailing address

1402 S Grand Blvd
Saint Louis, MO 63104-1004
Phone (314) 757-7869

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20230601003251 AR Practitioner - Pathology 7618246984 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Georgetown University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nephropathology Associates, PLCGroup PAC ID 6901707405, 30 clinicians

Practice addresses (Care Compare)

10810 Executive Ctr Dr
Suite 100
Little Rock, AR 72211-4386
Phone (501) 604-2695

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-15116ARMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nephropathology Associates, PLC CurrentSince May 18, 2023 Accepting new patients
Nephropathology Associates, PLC Past Accepting new patients

Locations

10810 Executive Center Dr
Ste 100
Little Rock, AR 72211
Phone (501) 604-2695

Organizations & group practices 2

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

Hospital & facility affiliations 8

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": "1491436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1578096533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041004",
            "telephone_number": "314-757-7869",
            "fax_number": "314-577-8374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10810 EXECUTIVE CENTER DR STE 100",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114386",
            "telephone_number": "501-604-2695",
            "fax_number": "501-604-2699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EIGBIRE-MOLEN",
        "first_name": "ODIANOSEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-06",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": "999999",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "AR",
            "license": "E-15116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.