NPIMap

Organization Active NPI

Odom Health and Wellness

  • Physical Therapy Clinic/Center
  • Silvis, IL
National Provider Identifier
1629463344
Registry record updated Mar 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
070020938 Issued in IL
Legal business name
ODOM HEALTH AND WELLNESS
Practice address
1900 10TH St
Silvis, IL 61282-1909
Phone
(309) 278-1537
NPI assigned
Mar 31, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2015

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

Authorized official

Name
Nicole Nash
Title
Operations Manager
Phone
(952) 224-1919

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 070020938 IL Primary

Addresses

Primary practice location

1900 10TH St
Silvis, IL 61282-1909

Mailing address

10500 Wayzata Blvd
Minnetonka, MN 55305-1511

National Provider Directory

National Provider Directory
Tax ID family
Odom Sports Medicine PA4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1427760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427760000000",
    "number": "1629463344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10500 WAYZATA BLVD",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553051511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 10TH ST",
            "city": "SILVIS",
            "state": "IL",
            "postal_code": "612821909",
            "telephone_number": "309-278-1537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ODOM HEALTH AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-31",
        "last_updated": "2015-03-31",
        "status": "A",
        "authorized_official_last_name": "NASH",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "952-224-1919"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "IL",
            "license": "070020938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silvis, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2015; 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.