Active NPI
Gina Leigh Odermann, D.C.
- Chiropractor
- Minneapolis, MN
National Provider Identifier
1689086134
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 5949
- Practice address
- 3706 Nicollet Ave
Minneapolis, MN 55409-1237 - Phone
- (612) 822-7509
- NPI assigned
- Jun 2, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 5949 | MN | Primary |
Addresses
Primary practice location
3706 Nicollet Ave
Minneapolis, MN 55409-1237
Mailing address
4217 Christy LN
Minnetonka, MN 55345-3001
Phone (218) 591-5299
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5949 | MN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401667200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559692800000",
"number": "1689086134",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4217 CHRISTY LN",
"city": "MINNETONKA",
"state": "MN",
"postal_code": "553453001",
"telephone_number": "218-591-5299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3706 NICOLLET AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554091237",
"telephone_number": "612-822-7509"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ODERMANN",
"first_name": "GINA",
"middle_name": "LEIGH",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-06-02",
"last_updated": "2019-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MN",
"license": "5949",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.