NPIMap

Individual provider Active NPI

John P Odonnell, PA-C

  • Physician Assistant
  • Lake City, FL
National Provider Identifier
1891795175
Registry record updated Aug 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA3548 Issued in FL
Practice address
173 NW Albritton LN
Lake City, FL 32055-4451
Phone
(386) 755-4020
NPI assigned
Jul 28, 2005
Last updated
Aug 15, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA3548 FL Primary

Addresses

Primary practice location

173 NW Albritton LN
Lake City, FL 32055-4451

Mailing address

8622 133Rd LN
Live Oak, FL 32060-8837
Phone (386) 208-4084

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071107000475 FL Practitioner - Physician Assistant 5092802033 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
May accept Medicare assignment
Group practices
Trenton Medical Center IncGroup PAC ID 2365359387, shared by 13 NPIs, 71 clinicians
Lake Area Physical Therapy Inc.Group PAC ID 3678604840, 372 clinicians

Practice addresses (Care Compare)

173 NW Albritton Lane
Lake City, FL 32055-4451
Phone (386) 755-4020

1830 N Main St
Bell, FL 32619-4713
Phone (352) 463-1100

PO Box
Melrose, FL 32666-1099

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Trenton Medical Center, Inc. CurrentSince Jul 21, 2014 Accepting new patients
Trenton Medical Center Inc CurrentSince Jul 21, 2014 Accepting new patients
North Florida Emergency Physicians Past Accepting new patients
Ipn Emergency Physicians of North Florida PA Physician Assistant Past Accepting new patients
Trenton Medical Center Inc Past Accepting new patients
Family Health Center of Columbia County, Inc. Physician Assistant Past Accepting new patients

Locations

1830 N Main St
Bell, FL 32619
Phone (352) 463-1100

103 US Highway 27 SW
Branford, FL 32008
Phone (386) 935-0542

410 N Main St
Ste 1
Chiefland, FL 32626
Phone (352) 369-0770

410 N Main St
Ste 12
Chiefland, FL 32626
Phone (352) 493-1686

2349 Village Square Pkwy
Ste 110111
Fleming Island, FL 32003
Phone (904) 385-2023

200 SW 62nd Blvd
Gainesville, FL 32607
Phone (352) 265-9484

16916 NW US Highway 441
High Springs, FL 32643
Phone (386) 454-0568

173 NW Albritton Ln
Lake City, FL 32055
Phone (386) 755-4020

4784 W US Highway 90
Lake City, FL 32055
Phone (386) 269-9260

211 Ranchera St NW
Live Oak, FL 32064
Phone (386) 364-1751

922 E Call St
#100
Starke, FL 32091
Phone (904) 364-2900

911 S Main St
Trenton, FL 32693
Phone (352) 463-2374

630 N Main St
Williston, FL 32696
Phone (352) 528-0587

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187136000000",
    "number": "1891795175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8622 133RD LN",
            "city": "LIVE OAK",
            "state": "FL",
            "postal_code": "320608837",
            "telephone_number": "386-208-4084",
            "fax_number": "386-752-9143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 NW ALBRITTON LN",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320554451",
            "telephone_number": "386-755-4020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODONNELL",
        "first_name": "JOHN",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2007-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA3548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake City, FL

Sources for this page

Verify at the official NPI Registry.