Thomas G. O'Daniel Jr., M.D.

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

24070 Issued in KY

Practice address

222 S 1St St
Suite 100
Louisville, KY 40202-1350

Phone

(502) 584-1109

Fax

(502) 589-6882

NPI assigned

Aug 15, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Aesthetic Plastic Surgery Institute of Louisville, LLC

  • Ambulatory Surgical Clinic/Center
  • Louisville, KY
  • NPI 1245346923
  NPD (past)
• Mark Chariker, M.D., PSC

  • Clinic/Center
  • Louisville, KY
  • NPI 1780853846
  NPD (past)

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459728000000",
    "number": "1871585018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 S 1ST ST",
            "address_2": "SUITE 100",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021350",
            "telephone_number": "502-584-1109",
            "fax_number": "502-589-6882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 S 1ST ST",
            "address_2": "SUITE 100",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021350",
            "telephone_number": "502-584-1109",
            "fax_number": "502-589-6882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DANIEL",
        "first_name": "THOMAS",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2016-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "KY",
            "license": "24070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100033340A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "002",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT PIN",
            "identifier": "1058697",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "667357",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "KY0057799",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET PIN",
            "identifier": "KY1118",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN",
            "identifier": "000000219660",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64240708",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer O'Connor
• Jessica O'Connor
• Mary Colleen O'Connor, LMT
• Joseph Anthony O'Daniel Jr., M.D.
• Tamalynn O'Daniel, APRN
• Theresa O'Day
• Amy O'Dell
• Danielle Elizabeth O'Dell, PA-C
• Patrick O'Dell
• Shannon Leigh O'Donnell, APRN

• Plastic and Reconstructive Surgery Physician in Louisville, KY
• Providers in Louisville, KY by specialty
• Plastic and Reconstructive Surgery Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2016; 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.