John P Odonnell, PA-C
Individual provider Active NPI Physician Assistant · Lake City, FL
NPI 1891795175 · NPPES record last updated Aug 15, 2007
Key facts
- NPI
- 1891795175
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA3548 (FL)
- Practice address
- 173 NW Albritton LN
Lake City, FL 32055-4451 - Phone
- (386) 755-4020
- NPI assigned
- Jul 28, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 17
Hospital & facility affiliations 8
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2004
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Trenton Medical Center Inc
Lake Area Physical Therapy Inc.
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
- Mederi Caretenders
- Suncrest Omni
- HCA Florida Lake City Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20071107000475 | FL | Practitioner - Physician Assistant | 5092802033 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Trenton Medical Center Inc | Current |
Accepting new patients | |
| Trenton Medical Center, Inc. | Current |
Accepting new patients | |
| Ipn Emergency Physicians of North Florida PA | Physician Assistant | Past | Accepting new patients |
| North Florida Emergency Physicians | 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) 395-3090
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
4784 W US Highway 90
Lake City, FL 32055
Phone (386) 269-9260
173 NW Albritton Ln
Lake City, FL 32055
Phone (386) 755-4020
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA3548 | FL | Yes |
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
Other providers in Lake City, FL
- Michael O'Rourke
- Christine O'Steen
- Stephen Lewis O'Steen
- Daniel Oakley
- Oasis of Hope Therapy LLC
- Allison Morgan Ogburn
- Renee Olson
- Adetokunbo Oluwasanjo
- Omni Home Health Hernando, LLC
- Omni Home Health- Hernando, LLC
All providers in Lake City, FL · Physician Assistant in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 15, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.