NPIMap

Individual provider Active NPI

Celestine Chukwunonso Odenigbo, M.D.

  • Internal Medicine Physician
  • Bloomer, WI
National Provider Identifier
1639430788
Registry record updated Sep 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
64732 Issued in WI
Practice address
1501 Thompson St
Bloomer, WI 54724
Phone
(715) 568-2000
NPI assigned
Jun 5, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 64732 WI Primary

Addresses

Primary practice location

1501 Thompson St
Bloomer, WI 54724

Mailing address

200 1St St SW
Rochester, MN 55905-0001
Phone (715) 838-5222

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address codenigbo24744@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20160831002368 WI Practitioner - Internal Medicine 0941596829 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2016
Medicare assignment
May accept Medicare assignment
Group practices
Spooner Health System IncGroup PAC ID 2062310287, 10 clinicians
Mayo Clinic Health System-Northwest Wisconsin Region IncGroup PAC ID 4385553627, shared by 21 NPIs, 797 clinicians

Practice addresses (Care Compare)

1280 Chandler Dr
Spooner, WI 54801-2202
Phone (715) 635-2111

1501 Thompson St
Bloomer, WI 54724-1257
Phone (715) 568-2000

Hospital & facility affiliations

  • Mayo Clinic Health System Chippewa Valley Hospital, Bloomer, WI, CCN 521314
  • Mayo Clinic Health System Eau Claire Hospital Hospital, Eau Claire, WI, CCN 520070
  • Mayo Clinic Health System-Northland Hospital, Barron, WI, CCN 521315
  • Mayo Clinic Health System-Red Cedar Inc Hospital, Menomonie, WI, CCN 521340
  • Mayo Clinic Health System Chippewa Valley Nursing home, CCN 52Z314

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
64732WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. Current Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince Jan 1, 2018 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. Current Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince Jan 1, 2018 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. Current Accepting new patients
Spooner Health System, Inc. CurrentSince Dec 11, 2024 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. Current Accepting new patients

Locations

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

1222 E Woodland Ave
Barron, WI 54812
Phone (715) 537-3166

1501 Thompson St
Bloomer, WI 54724
Phone (715) 568-2000

733 W Clairemont Ave
Eau Claire, WI 54701
Phone (715) 838-3806

2321 Stout Rd
Menomonie, WI 54751
Phone (715) 235-5531

13025 8th St
Osseo, WI 54758
Phone (715) 597-2575

1280 Chandler Dr
Spooner, WI 54801
Phone (715) 635-2111

Organizations & group practices 9

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 5

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": "1338854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662076800000",
    "number": "1639430788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "715-838-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 THOMPSON ST",
            "city": "BLOOMER",
            "state": "WI",
            "postal_code": "54724",
            "telephone_number": "715-568-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODENIGBO",
        "first_name": "CELESTINE",
        "middle_name": "CHUKWUNONSO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-05",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "64732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "codenigbo24744@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "1501 Thompson St",
            "city": "Bloomer",
            "state": "WI",
            "country_code": "US",
            "postal_code": "54724",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bloomer, WI

Sources for this page

Verify at the official NPI Registry.