Active NPI
Renee Odell, ST
- Ophthalmic Assistant
- Phoenix, AZ
National Provider Identifier
1821453689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmic Assistant
- License
- 207W00000X
- Practice address
- 1750 E Glendale Ave
Phoenix, AZ 85020-5505 - Phone
- (602) 242-4928
- Fax
- (602) 249-4813
- NPI assigned
- Dec 22, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Ophthalmic Assistant | 156FX1101X | 207W00000X | AZ | Primary |
Addresses
Primary practice location
1750 E Glendale Ave
Phoenix, AZ 85020-5505
Mailing address
1750 E Glendale Ave
Phoenix, AZ 85020-5505
Phone (602) 242-4928
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 207W00000X | AZ | MD | Ophthalmic Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1450742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1450742400000",
"number": "1821453689",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1750 E GLENDALE AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850205505",
"telephone_number": "602-242-4928",
"fax_number": "602-249-4813"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1750 E GLENDALE AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850205505",
"telephone_number": "602-242-4928",
"fax_number": "602-249-4813"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ODELL",
"first_name": "RENEE",
"name_prefix": "Mrs.",
"credential": "ST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-12-22",
"last_updated": "2015-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1101X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Ophthalmic Assistant",
"state": "AZ",
"license": "207W00000X",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.