Active NPI
Douglas Melvin Odegaard Jr., RPH
- Pharmacotherapy Pharmacist
- Whiteman Afb, MO
National Provider Identifier
1891714796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacotherapy Pharmacist
- License
- PS38291
- Practice address
- 331 Sijan Ave
509 Mdos CC
Whiteman Afb, MO 65305-1269 - Phone
- (660) 687-1194
- NPI assigned
- Jul 19, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pharmacotherapy Pharmacist | 1835P1200X | PS38291 | FL | Primary |
Addresses
Primary practice location
331 Sijan Ave
509 Mdos CC
Whiteman Afb, MO 65305-1269
Mailing address
730 Lindbergh St
Whiteman Afb, MO 65305-1134
Phone (727) 433-2472
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS38291 | FL | MD | Pharmacotherapy Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477612800000",
"number": "1891714796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "730 LINDBERGH ST",
"city": "WHITEMAN AFB",
"state": "MO",
"postal_code": "653051134",
"telephone_number": "727-433-2472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "331 SIJAN AVE",
"address_2": "509 MDOS CC",
"city": "WHITEMAN AFB",
"state": "MO",
"postal_code": "653051269",
"telephone_number": "660-687-1194"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ODEGAARD",
"first_name": "DOUGLAS",
"middle_name": "MELVIN",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-19",
"last_updated": "2016-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "FL",
"license": "PS38291",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Whiteman Afb, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.