Innocent Odocha MD PA

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

ME86683 Issued in FL

Legal business name

INNOCENT ODOCHA MD PA

Practice address

816 NW 13TH St
Gainesville, FL 32601-2903

Phone

(352) 371-3212

Fax

(352) 371-3213

NPI assigned

Mar 20, 2007

Last updated

May 14, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Innocent Odocha, MDNPI 1568560829

Title

President

Phone

(352) 371-3212

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Tax ID family

Innocent Nwokedi Odocha MD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Innocent Odocha, M.D.,P.a.

  dba Odocha Family Medicine and Associates

  • Family Medicine Physician
  • Gainesville, FL
  • NPI 1477719763
  NPD tax ID

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Innocent N. Odocha, MD

  • Family Medicine Physician
  • Gainesville, FL
  • NPI 1568560829
  Medicare reassignment Care Compare group NPD Authorized official
• Cody Gerhart, A.R.N.P

  • Nurse Practitioner
  • Gainesville, FL
  • NPI 1437501608
  Medicare reassignment Care Compare group NPD
• Alexandra Odocha, ARNP

  • Adult Health Nurse Practitioner
  • Gainesville, FL
  • NPI 1356500771
  Medicare reassignment Care Compare group NPD
• Katherine Swan, ARNP FNP-BC

  • Family Nurse Practitioner
  • Gainesville, FL
  • NPI 1245671452
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242259200000",
    "number": "1780709998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 NW 13TH ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326012903",
            "telephone_number": "352-371-3212",
            "fax_number": "352-371-3213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 NW 13TH ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326012903",
            "telephone_number": "352-371-3212",
            "fax_number": "352-371-3213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOCENT ODOCHA MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2009-05-14",
        "status": "A",
        "authorized_official_last_name": "ODOCHA",
        "authorized_official_first_name": "INNOCENT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-371-3212",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "ME86683",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "266453400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00179043",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "57823",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Doron Ingram
• Tia Tiana Ingram
• Inner Harmony Psychotherapy LLC
• Inner Path Counseling, LLC
• Veronika Innis
• Innocent Odocha, M.D.,P.a. (Odocha Family Medicine and Associates)
• Innovate Health Medical Clinic Corp
• Innovation Home Health Care LLC
• Innovative Back Solutions,LLC
• Innovexlab

• Primary Care Clinic/Center in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.