Lan O'Donnell, O.D., M.S.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC 3968 Issued in FL

Practice address

870 Mack Bayou Rd
Santa Rosa Beach, FL 32459-7150

Phone

(850) 622-4000

Fax

(850) 622-0072

NPI assigned

Oct 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Lan Q. O'Donnell, O.D., P.a.

  • Optometrist
  • Santa Rosa Beach, FL
  • NPI 1356438634
  NPD Authorized official

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831286111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "870 MACK BAYOU RD",
            "city": "SANTA ROSA BEACH",
            "state": "FL",
            "postal_code": "324597150",
            "telephone_number": "850-622-4000",
            "fax_number": "850-622-0072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "870 MACK BAYOU RD",
            "city": "SANTA ROSA BEACH",
            "state": "FL",
            "postal_code": "324597150",
            "telephone_number": "850-622-4000",
            "fax_number": "850-622-0072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DONNELL",
        "first_name": "LAN",
        "credential": "O.D., M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 3968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kim Khanh Thi Nguyen, PHARM.D
• Ryan Nicholas Nolte, M.D.
• North Florida Surgeons, PA
• Northwest Florida Home Care, Inc.
• Livingston Nuamah, DPM
• Michael O'Donnell, D.M.D.
• Lisa E O'Neill, APRN
• Grant Forsyth Oberle, BHS
• Optikk 30a, PA
• Tanya Orr, DDS

• Optometrist in Santa Rosa Beach, FL
• Providers in Santa Rosa Beach, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.