DONALD MARK ODLAND (NPI# 1417928979) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417928979 |
| Entity Type | Individual |
| Full Name | DONALD MARK ODLAND |
| Credential | MD |
| Practice Address |
111 17th Ave E Alexandria MN 56308-5273 |
| Practice Telephone | 3207621511 |
| Practice Fax Number | 3207626101 |
| Mailing Telephone | 3207621144 |
| Mailing Fax Number | 3027626101 |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2018-02-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
27748 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | PHP-ID | 39-47050 | 01 |
| MN | RR MEDICARE | 080099857 | 01 |
| MN | MET | 089000132 | 01 |
| MN | 626868400 | 05 | |
| MN | HEALTHPARTNERS | HP22829 | 01 |
| MN | BC/BS | 27652OD | 01 |
| Street Address |
111 17TH AVE E |
| City | ALEXANDRIA |
| State | MN |
| Zip Code | 56308-5273 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164424305 | Douglas County Hospital | General Acute Care Hospital | 111 17th Ave E, Alexandria, MN 56308-3703 | 2005-06-01 |
| 1679047013 | Kayla Hughes | Nurse Anesthetist, Certified Registered | 111 17th Ave E, Alexandria, MN 56308-5273 | 2019-01-18 |
| 1750776530 | Benjamin Andrew Kitt | Emergency Medicine | 111 17th Ave E, Alexandria, MN 56308-5273 | 2015-03-30 |
| 1760873491 | Amanda Kristine Nefstead | Specialist/Technologist | 111 17th Ave E, Suite 101, Alexandria, MN 56308-5273 | 2015-02-17 |
| 1558767483 | Samantha Bourcy | Specialist/Technologist | 111 17th Ave E, Suite 101, Alexandria, MN 56308-5273 | 2014-11-04 |
| 1083029490 | Amanda Leigh Knettel | Physical Therapist | 111 17th Ave E, Alexandria, MN 56308-5273 | 2014-06-24 |
| 1538573613 | Dane Jason Mitteness | Emergency Medicine | 111 17th Ave E, Alexandria, MN 56308-5273 | 2014-06-17 |
| 1013334572 | Meghan Ruhr | Registered Nurse | 111 17th Ave E, Alexandria, MN 56308-5273 | 2014-03-23 |
| 1598196149 | Heidi Stark | Specialist/Technologist | 111 17th Ave E, Suite 101, Alexandria, MN 56308-5273 | 2013-12-09 |
| 1396174330 | Michael James Kunstle | Physician Assistant | 111 17th Ave E, Suite 101, Alexandria, MN 56308-3734 | 2013-11-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871104836 | Center for Pain Management Ambulatory Surgery, Ltd | Pain Medicine | 804 23rd Street South, Sartell, MN 56308 | 2020-08-13 |
| 1548815590 | Ritajo Ellenberger | Licensed Practical Nurse | 220 Oak Street North, Alexandria, MN 56308 | 2019-08-06 |
| 1346808714 | Vance Thompson Vision Surgery Center Alexandria, Prof LLC | Clinic/Center | 2600 Jefferson St, Alexandria, MN 56308 | 2019-05-31 |
| 1811452048 | Little Falls Eye Care Center Pa | Optometrist | 2306 S. Broadway Str. Suite 12, Alexandria, MN 56308 | 2019-02-01 |
| 1184167199 | Jennifer Lynn Craig | Technician | 2307 East Golf Course Rd, Alexandria, MN 56308 | 2016-11-22 |
| 1548712219 | Shelby Elisha Johnsrud | Chiropractor | 303 West 22nd Ave, Ste 100, Alexandria, MN 56308 | 2016-10-28 |
| 1811347867 | Dustin Matthew Ditch | Dentist | 510 22nd Ave E Ste 702, Alexandria, MN 56308 | 2016-06-20 |
| 1639538051 | West Central Chiropractic & Wellness, LLC | Chiropractor | 123 3rd Ave. E, Suite 100, Alexandria, MN 56308 | 2016-02-12 |
| 1659736221 | Amanda Jean Dahlseng | Registered Nurse | 809 Elm Street, Suite 1200, Alexandria, MN 56308 | 2015-12-23 |
| 1518358886 | Benjamin G Wenzel | Marriage & Family Therapist | 512 30th Ave S, Ste 100, Alexandria, MN 56308 | 2015-02-09 |
| Find all providers in zip 56308 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629139969 | Eugene Francis Delaune IIi | Emergency Medicine | 7804 Accotink Pl, Alexandria, VA 22308-1226 | 2006-12-12 |
| 1891781233 | Sara E. Kelly | Emergency Medicine | 224 Pecan Park Ave, Alexandria, LA 71303-3308 | 2005-09-21 |
| 1396304499 | Alexandria Ep, LLC | Emergency Medicine | 5900 Coliseum Blvd, Alexandria, LA 71303-3714 | 2019-06-12 |
| 1891275640 | Mary T Conell | Emergency Medicine | 4320 Seminary Rd, Alexandria, VA 22304-1535 | 2018-08-20 |
| 1093902082 | James Huey Hebert | Emergency Medicine | 3330 Masonic Dr, Alexandria, LA 71301-3841 | 2007-10-03 |
| 1508947300 | Southern Emergency Consultants, LLC | Emergency Medicine | 3330 Masonic Dr, Alexandria, LA 71301-3841 | 2006-10-18 |
| 1275540841 | David Charash | Emergency Medicine | 2501 Parkers Ln, Alexandria, VA 22306-3209 | 2006-08-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457901506 | Centracare Health System | Emergency Medicine | 121 Lake St N, Big Lake, MN 55309-9254 | 2019-09-19 |
| 1700082781 | Jeffrey A Lee | Emergency Medicine | 111 Riverfront Ste 208, Winona, MN 55987-3456 | 2007-06-26 |
| 1669544623 | Thomas Charles Koehnen | Emergency Medicine | 38818 730th Ave, Saint James, MN 56081-4482 | 2006-11-14 |
| 1952385304 | Tracy Alan Powell | Emergency Medicine | 303 Catlin St, Buffalo, MN 55313-1947 | 2005-11-30 |
| 1831548676 | Sarah Mott | Emergency Medicine | 1575 Beam Ave, Maplewood, MN 55109-1126 | 2016-06-10 |
| 1508129198 | Amy M. O'neil | Emergency Medicine | 200 1st St Sw, Rochester, MN 55905-0001 | 2012-06-19 |
| 1285994517 | Micah Richard Treuer | Emergency Medicine | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2012-05-21 |
| 1528324472 | Erin Austad | Emergency Medicine | 333 Smith Ave N, Saint Paul, MN 55102-2344 | 2012-04-04 |
| 1740457902 | Ram Prasad Paneru | Emergency Medicine | 123 4th St Nw, Bagley, MN 56621-8306 | 2008-05-15 |
| 1417123688 | Samuel Robert Goblirsch | Emergency Medicine | 701 Dellwood St S, Cambridge, MN 55008-1920 | 2008-05-07 |
| Find all providers with the same taxonomy | ||||
| City | ALEXANDRIA |
| Zip Code | 56308 |
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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.