INNOCENT ODOCHA MD PA (NPI# 1780709998) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780709998 |
| Entity Type | Organization |
| Organization Name | INNOCENT ODOCHA MD PA |
| Practice Address |
816 Nw 13th St Gainesville FL 32601-2903 |
| Practice Telephone | 3523713212 |
| Practice Fax Number | 3523713213 |
| Mailing Telephone | 3523713212 |
| Mailing Fax Number | 3523713213 |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2009-05-14 |
| Authorized Official Name | DR. INNOCENT ODOCHA (PRESIDENT) |
| Authorized Official Telephone | 3523713212 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
ME86683 | FL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD | 57823 | 01 | |
| FL | 266453400 | 05 | |
| RAILROAD MEDICARE | P00179043 | 01 |
| Street Address |
816 NW 13TH ST |
| City | GAINESVILLE |
| State | FL |
| Zip Code | 32601-2903 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699298059 | Burton Burt | Counselor | 816 Nw 13th St, Gainesville, FL 32601-2903 | 2017-07-18 |
| 1245671452 | Katherine Swan | Nurse Practitioner | 816 Nw 13th St, Gainesville, FL 32601-2903 | 2013-07-16 |
| 1700169505 | Cynthia Boucher | Nurse Practitioner | 816 Nw 13th St, Gainesville, FL 32601-2903 | 2011-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316584675 | Gainesville Peer Respite, Inc. | Peer Specialist | 728 E. University Avenue, Gainesville, FL 32601 | 2019-12-05 |
| 1376008375 | Three Treasures Holistic Care, LLC | Counselor | 2727 B Nw 43rd St, Suite B, Gainesville, FL 32601 | 2019-02-04 |
| 1376060301 | Healing Elements Integrative Acupuncture LLC | Acupuncturist | 305 Se 2cd Ave, Gainesville, FL 32601 | 2017-08-30 |
| 1477078327 | Lisa Anderson | Acupuncturist | 1000 Ne 16th Ave Bldg I Suite A, Gainesville, FL 32601 | 2017-08-11 |
| 1336590892 | Cheryl Fraley | Counselor | 1408 Nw 6th Street, Gainesville, FL 32601 | 2016-06-27 |
| 1710357363 | Erika Chase | Acupuncturist | 305 Se 2cd Avenue, Gainesville, FL 32601 | 2015-09-25 |
| 1811300148 | Stephanie Adamczak | Student in an Organized Health Care Education/Training Program | 1149 South Newell Drive, Gainesville, FL 32601 | 2014-06-04 |
| 1477979441 | Mary Santello | Mechanotherapist | 115 Ne 6th Terrace, Suite 205, Gainesville, FL 32601 | 2014-03-13 |
| 1740628957 | Caitlyn Kloss | Specialist | 900 Nw 8th Avenue, Gainesville, FL 32601 | 2013-06-10 |
| 1992054886 | Anthony Lorne Johnson | Massage Therapist | 1330 Nw 6th St Suite A, Gainesville, FL 32601 | 2012-09-06 |
| Find all providers in zip 32601 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649811928 | Careatc | Clinic/Center | 1314 W Ridge Rd, Gainesville, GA 30501-6932 | 2019-10-08 |
| 1982143079 | Celebrate Primary Care | Clinic/Center | 4400 Nw 23rd Ave Ste B, Gainesville, FL 32606-6562 | 2017-02-22 |
| 1588054415 | Dr. Stephen Ellis Landay | Clinic/Center | 7109 Nw 11th Pl Ste E, Gainesville, FL 32605-3141 | 2015-01-30 |
| 1053747188 | Pediatrics & Family Medicine of Buena Vista, LLC | Clinic/Center | 10552 Nw 13th Ave, Gainesville, FL 32606-8088 | 2013-09-20 |
| 1558606335 | Primary Care of Gainesville LLC | Clinic/Center | 1026 Sw 2nd Ave Ste C, Gainesville, FL 32601-8182 | 2012-12-04 |
| 1164443255 | Shamal D Nadkarni Md Pa | Clinic/Center | 1026 Sw 2nd Ave, Suite D, Gainesville, FL 32601-6134 | 2006-07-22 |
| 1538794326 | Psk Management LLC | Clinic/Center | 1364 Nw 121st Way, Gainesville, FL 32606-5274 | 2020-03-12 |
| 1720514029 | Lakeside Family Medicine | Clinic/Center | 104 Carrington Park Dr Ste B, Gainesville, GA 30504-6603 | 2017-05-04 |
| 1124478078 | Prosalud Medical Center | Clinic/Center | 1870 Atlanta Rd, Ste J, Gainesville, GA 30504-5948 | 2016-06-21 |
| 1124441241 | Jones Family Medical, Pllc | Clinic/Center | 413 E Broadway St, Gainesville, TX 76240-4169 | 2014-01-24 |
| Find all providers in GAINESVILLE | ||||
| City | GAINESVILLE |
| Zip Code | 32601 |
Please comment or provide details below to improve the information on INNOCENT ODOCHA MD PA.
| 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.