COURTNEY MARIE O'DONNELL
NPI 1790625754
Student in an Organized Health Care Education/Training Program in Fort Wayne, IN

Q: What is Courtney O'donnell's NPI number?

The NPI number for Courtney O'donnell is 1790625754. It was assigned to this individual provider in the NPPES registry on March 30, 2026.

Q: What is Courtney O'donnell's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Active since March 30, 2026PECOS Enrolled

2200 RANDALLIA DR, FORT WAYNE, IN 46805(260) 373-7765 Get Directions Write a Review

NPPES record last updated: March 30, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Courtney Marie O'donnell NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COURTNEY MARIE O'DONNELL (NPI 1790625754) is an individual student in an organized health care education/training program in Fort Wayne, Indiana and active in the NPI registry since March 2026. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1790625754

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameCOURTNEY MARIE O'DONNELL

Location Address2200 RANDALLIA DRFort Wayne, IN 46805-4638

Mailing Address2200 Randallia DrFort Wayne, IN 46805-4638 · (260) 373-7765

Phone(260) 373-7765

Sole ProprietorNo

Enumeration DateMarch 30, 2026

NPPES CertifiedMarch 30, 2026

✔ NPI 1790625754 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

2200 RANDALLIA DR, Fort Wayne, IN 46805

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Courtney Marie O'donnell is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MALLIKA GYAWALI MD

Internal Medicine