RILEY ODOM (NPI# 1437659190) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437659190 |
| Entity Type | Individual |
| Full Name | RILEY ODOM |
| Credential | NP-C |
| Practice Address |
559 Capitol Blvd Saint Paul MN 55103-2101 |
| Mailing Address |
2318 Taft St Ne Minneapolis MN 55418-4132 |
| Practice Telephone | 6512322000 |
| Enumeration Date | 2018-02-19 |
| Last Update Date | 2018-03-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LC0200X |
Nurse Practitioner Specialization: Critical Care Medicine |
5737 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
559 CAPITOL BLVD |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55103-2101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114987245 | Karen E. Miller | Internal Medicine | 559 Capitol Blvd, Saint Paul, MN 55103-2101 | 2006-03-24 |
| 1659911089 | Mitchell Allen Peterson | Physical Therapist | 559 Capitol Blvd, Saint Paul, MN 55103-2101 | 2020-01-14 |
| 1134689193 | Jeremy Tvrdik | Physical Therapist | 559 Capitol Blvd, Saint Paul, MN 55103-2101 | 2019-03-24 |
| 1932666518 | Eliesa Woggon | Occupational Therapist | 559 Capitol Blvd, Saint Paul, MN 55103-2101 | 2019-03-01 |
| 1558828228 | Tina Denise Stone | Occupational Therapist | 559 Capitol Blvd, Saint Paul, MN 55103-2101 | 2019-02-28 |
| 1053877514 | Jennifer Joy Rovn | Physical Therapist | 559 Capitol Blvd, Saint Paul, MN 55103-2101 | 2019-02-20 |
| 1154887685 | Danetta Lavell | Occupational Therapist | 559 Capitol Blvd, Saint Paul, MN 55103-2101 | 2019-02-20 |
| 1215476437 | Kayla Appleby | Social Worker | 559 Capitol Blvd, Saint Paul, MN 55103-2101 | 2017-02-21 |
| 1659821452 | Jenna Jenkins | Speech-Language Pathologist | 559 Capitol Blvd, Saint Paul, MN 55103-2101 | 2016-10-05 |
| 1841645942 | Danielle Koenig | Nurse Practitioner | 559 Capitol Blvd, Saint Paul, MN 55103-2101 | 2016-04-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972148161 | Najma Group Home LLC | Home Health | 494 Aurora Ave, St Paul, MN 55103 | 2019-11-12 |
| 1164910121 | Linda's A Mother's Touch | Registered Nurse | 727 Front Ave Apt 606, St. Paul, MN 55103 | 2018-04-25 |
| 1215432380 | Olidia Transit Inc | Non-emergency Medical Transport (VAN) | 476 W Minnehaha Ave, Saint Paul, MN 55103 | 2018-03-29 |
| 1730579764 | Leah Angela Vibar | Chiropractor | 616 Rice Street Ste. B, Moua-lor Chiropractic & Acupuncture, P.a., St. Paul, MN 55103 | 2015-01-29 |
| 1629372479 | Korme Koji | Registered Nurse | 413 Central Avenue, St Paul, MN 55103 | 2011-01-07 |
| 1427360114 | Olydia Home Care Inc | Home Health | 476 West Minnehaha Ave, Saint Paul, MN 55103 | 2010-07-09 |
| 1699908277 | Kathleen Mae Borchert | Clinical Nurse Specialist | 559 Capitol Bloulevard, St. Paul, MN 55103 | 2009-08-28 |
| 1164690442 | Chong Pao Thao | Technician | 23 Empire Drive, Suite 123, St Paul, MN 55103 | 2008-02-20 |
| 1245366806 | Quality Plus Home Healthcare Services Inc | Home Health | 383 University Ave W. Upper, St Paul, MN 55103 | 2007-02-26 |
| 1023176286 | Amherst H. Wilder Foundation | Assisted Living Facility | 280 Ravoux St, Saint Paul, MN 55103 | 2006-12-04 |
| Find all providers in zip 55103 | ||||
| Taxonomy Code | 363LC0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Critical Care Medicine |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386805067 | Steven Andrew Mcdonald | Nurse Practitioner | 420 Delaware St Se, Minneapolis, MN 55455-0341 | 2008-06-24 |
| 1700991098 | Durae June Pfeffer | Nurse Practitioner | 400 E 3rd St, Duluth, MN 55805-1951 | 2006-08-20 |
| 1508898156 | Sara Ann Forrest | Nurse Practitioner | 400 E 3rd St, Duluth, MN 55805-1951 | 2006-07-06 |
| 1184668576 | Cheryl Swenson | Nurse Practitioner | 3300 Oakdale Ave N, Robbinsdale, MN 55422-2926 | 2006-06-15 |
| 1609866201 | Amy L Kramer | Nurse Practitioner | 1200 6th Ave N, Saint Cloud, MN 56303-2735 | 2005-10-25 |
| City | SAINT PAUL |
| Zip Code | 55103 |
Please comment or provide details below to improve the information on RILEY ODOM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.