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Contact Information

ODYSSEY ENTERPRISES LLC
2559 S ADDISYN LN
BLOOMINGTON, IN47403-3269
 Phone: 317-349-7680
 Fax: 833-975-0724
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Adult Medicine

207QA0505X 08 Physician/Family Practice
 

Geriatric Medicine

207QG0300X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for ODYSSEY ENTERPRISES LLC

NPI Number 1699514711
LBN Legal business name ODYSSEY ENTERPRISES LLC
Authorized official JAMES PENTICUFF - (PRACTICE ADMINISTRATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 05/20/2024
Last updated 05/20/2024 - About 2 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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