DR. RANDALL R ODEM (NPI# 1336165554) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336165554 |
| Entity Type | Individual |
| Full Name | DR. RANDALL R ODEM |
| Credential | MD |
| Practice Address |
4444 Forest Park Ave Ste 3100 Ste 3100 Saint Louis MO 63108-2212 |
| Mailing Address |
660 S Euclid Ave C B 8064 Saint Louis MO 63110-1010 |
| Practice Telephone | 3142862400 |
| Practice Fax Number | 3142862455 |
| Mailing Telephone | 3142862400 |
| Mailing Fax Number | 3142862455 |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2019-03-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VE0102X |
Obstetrics & Gynecology Specialization: Reproductive Endocrinology |
R7E33 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | ENROLLED | 05 | |
| MO | 202236402 | 05 |
| Street Address |
4444 FOREST PARK AVE STE 3100 STE 3100 |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63108-2212 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235160748 | Sarah L Keller | Obstetrics & Gynecology | 4444 Forest Park Ave Ste 3100, Ste 3100, Saint Louis, MO 63108-2212 | 2006-07-05 |
| 1477738136 | Kenan Rifat Omurtag | Obstetrics & Gynecology | 4444 Forest Park Ave Ste 3100, Ste 3100, Saint Louis, MO 63108-2212 | 2007-12-31 |
| 1205852449 | Kelle H Moley | Obstetrics & Gynecology | 4444 Forest Park Ave Ste 3100, Ste 3100, Saint Louis, MO 63108-2212 | 2006-07-14 |
| 1942226170 | Valerie Ratts | Obstetrics & Gynecology | 4444 Forest Park Ave Ste 3100, Ste 3100, Saint Louis, MO 63108-2212 | 2006-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346851474 | Nigel Austen Thomas Cook | Social Worker | 4050 West Pine Blvd. Apt. 4118, St. Louis, MO 63108 | 2020-08-12 |
| 1467070011 | C2n Diagnostics, LLC | Clinical Medical Laboratory | 20 South Sarah Street, Saint Louis, MO 63108 | 2020-07-10 |
| 1609414358 | Kaylee Breitenbucher | Occupational Therapist | 4444 Forest Park Avenue, Msc 8505-94-01, St. Louis, MO 63108 | 2019-12-12 |
| 1114419546 | Activangels Home Health | Home Health | 4625 Lindell Blvd Ste 304, Saint Louis, MO 63108 | 2018-06-01 |
| 1215427349 | Heart To Heart Consolidated Home Care Service LLC | Home Health | 4625 Lindell Blvd Ste 200, Saint Louis, MO 63108 | 2018-05-15 |
| 1447755905 | Erin Virginia Adams | Student in an Organized Health Care Education/Training Program | 4355 Maryland Ave Apt 116, Saint Louis, MO 63108 | 2018-03-27 |
| 1033621172 | Roots Healthcare and Homes | In Home Supportive Care | 4300 Enright Ave, St. Louis, MO 63108 | 2017-10-30 |
| 1336661719 | House of Destiny Adult Day Care LLC | Clinic/Center | 4507 Olive Street, St Louis, MO 63108 | 2017-07-07 |
| 1003338492 | Khin Min Thu | Social Worker | 4236 Lindell Blvd., Suite 200, St Louis, MO 63108 | 2017-07-07 |
| 1679093967 | Together We Can Home Healthcare Services LLC | Home Health | 4144 Lindell Blvd Suite 221, Saint Louis, MO 63108 | 2017-06-27 |
| Find all providers in zip 63108 | ||||
| Taxonomy Code | 207VE0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Reproductive Endocrinology |
| An obstetrician/gynecologist who is capable of managing complex problems relating to reproductive endocrinology and infertility. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063525038 | Peter Ahlering | Obstetrics & Gynecology | 555 N Ballas Rd, #150, Saint Louis, MO 63141 | 2006-08-16 |
| 1235160748 | Sarah L Keller | Obstetrics & Gynecology | 4444 Forest Park Ave Ste 3100, Ste 3100, Saint Louis, MO 63108-2212 | 2006-07-05 |
| 1932178845 | Berold I Witten | Obstetrics & Gynecology | 555 N New Ballas Rd Ste 150, Saint Louis, MO 63141-6843 | 2006-03-14 |
| 1336766492 | Stlfertility LLC | Obstetrics & Gynecology | 555 N New Ballas Rd Ste 150, Saint Louis, MO 63141-6843 | 2020-07-06 |
| 1023473279 | Vios Fertility Institute St. Louis, LLC | Obstetrics & Gynecology | 621 S New Ballas Rd, Tower A, Suite 260, Saint Louis, MO 63141-8232 | 2015-12-15 |
| 1245537778 | Center for Reproductive Medicine and Robotic Surgery, LLC | Obstetrics & Gynecology | 522 N New Ballas Rd, Suite 206, Saint Louis, MO 63141-6857 | 2011-02-18 |
| 1003019217 | Patricia Tereese Jimenez | Obstetrics & Gynecology | 4444 Forest Park Ave, Ste 3100, Saint Louis, MO 63108-2212 | 2007-06-06 |
| 1720206063 | St Louis University | Obstetrics & Gynecology | 1031 Bellevue Ave, Saint Louis, MO 63117-1818 | 2007-04-23 |
| 1871632364 | Amber R Cooper | Obstetrics & Gynecology | 3023 N Ballas Rd, Ste 450 Bldg D, Saint Louis, MO 63131-2330 | 2007-02-05 |
| 1730107152 | James R Schreiber | Obstetrics & Gynecology | 4921 Parkview Pl, 5th Fl Womens Health Center, Saint Louis, MO 63110-1032 | 2006-07-17 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63108 |
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| 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.