KEITH WAYNE ODENDAHL N.P. NPI 1811977846

NPI Information

NPI: 1811977846
Provider Name: KEITH WAYNE ODENDAHL, N.P.
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Individual

Specialization: Adult Health

Organization: DM PROPERTIES OF LAFAYETTE, LLC

PECOS Registration: Yes

Address:
7777 HENNESSY BLVD
SUITE1000
BATON ROUGE, LA
ZIP 70808
Phone: (225) 767-3900
Get Directions

Keith Wayne Odendahl, N.P. is an adult health nurse practitioner in Baton Rouge, LA with 24 years of experience. Keith Wayne Odendahl, N.P. NPI is 1811977846. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

7777 HENNESSY BLVD
SUITE1000
BATON ROUGE, LA
ZIP 70808-300
Phone: (225) 767-3900
Fax: (225) 214-9109

The NPI 1811977846 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/17/2006 and was last updated on 12/16/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2200X	Nurse Practitioner	Adult Health	AP03719	LOUISIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1431940	MEDICAID	LOUISIANA
2	310063	OTHER	LOUISIANA	WELLCARE
3	P51192	MEDICARE UPIN	LOUISIANA
4	4B512C921	MEDICARE ID-TYPE UNSPECIFIED	LOUISIANA
5	4B512CQ60	MEDICARE PIN	LOUISIANA
6	P00712670	OTHER	LOUISIANA	RAILROAD MCARE THRU PEPA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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