DR. AUDREY R ODOM (NPI# 1215949276) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215949276 |
| Entity Type | Individual |
| Full Name | DR. AUDREY R ODOM |
| Credential | MD |
| Practice Address |
1 Childrens Pl Ste C Ste C Saint Louis MO 63110-1002 |
| Mailing Address |
1 Childrens Pl Cb 8116 Saint Louis MO 63110-1002 |
| Practice Telephone | 3144546050 |
| Practice Fax Number | 3144542836 |
| Mailing Telephone | 3144546050 |
| Mailing Fax Number | 3144542836 |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2018-01-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | 2008022993 | MO | Allopathic & Osteopathic Physicians |
| Y | 2080P0208X |
Pediatrics Specialization: Pediatric Infectious Diseases |
2008022993 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 1215949276 | 05 | |
| IL | ENROLLED | 05 |
| Street Address |
1 CHILDRENS PL STE C STE C |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63110-1002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164428389 | Tasnim A Najaf | Pediatrics | 1 Childrens Pl Ste C, Ste C, Saint Louis, MO 63110-1002 | 2005-06-22 |
| 1942712278 | Claire Elizabeth Seper | Nurse Practitioner | 1 Childrens Pl Ste C, Ste C, Saint Louis, MO 63110-1002 | 2017-10-26 |
| 1801333018 | Elizabeth Rose Toolan | Dietitian, Registered | 1 Childrens Pl Ste C, Ste C, Saint Louis, MO 63110-1002 | 2017-01-25 |
| 1184161820 | Linda Piersall Manwaring | Genetic Counselor, MS | 1 Childrens Pl Ste C, Ste C, Saint Louis, MO 63110-1002 | 2017-01-19 |
| 1891231544 | Marisa Vineyard Andrews | Genetic Counselor, MS | 1 Childrens Pl Ste C, Ste C, Saint Louis, MO 63110-1002 | 2017-01-18 |
| 1467998112 | Elise Marguerite Fiala | Genetic Counselor, MS | 1 Childrens Pl Ste C, Ste C, Saint Louis, MO 63110-1002 | 2017-01-18 |
| 1487019394 | Ericka Lauren Louer | Nurse Practitioner | 1 Childrens Pl Ste C, Ste C, Saint Louis, MO 63110-1002 | 2015-12-18 |
| 1588043632 | Diana Lynn Culbertson | Pediatrics | 1 Childrens Pl Ste C, Ste C, Saint Louis, MO 63110-1002 | 2015-05-21 |
| 1790106391 | Andrea Nicole Herkenhoff | Nurse Practitioner | 1 Childrens Pl Ste C, Ste C, Saint Louis, MO 63110-1002 | 2013-12-27 |
| 1235490400 | Brooke I Polk | Pediatrics | 1 Childrens Pl Ste C, Ste C, Saint Louis, MO 63110-1002 | 2012-06-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659971992 | Carrie Ellen Smith | Nurse Practitioner | Mailstop 90-00-174, One Barnes-jewish Plaza, St. Louis, MO 63110 | 2020-10-27 |
| 1881210466 | Michelle Amanda Freilich | Internal Medicine | Barnes-jewish Plaza, St. Louis, MO 63110 | 2020-06-19 |
| 1245856046 | Jeevin Shahi | Radiology | 3685 Vista Avenue, Center for Radiation Medicine, St. Louis, MO 63110 | 2020-06-18 |
| 1497371314 | Wilson Eduardo Rodriguez | Student in an Organized Health Care Education/Training Program | 1008 S. Spring, St Louis, MO 63110 | 2020-06-17 |
| 1578184065 | Kathryn Kay Lindsay | Registered Nurse | Saint Louis University Dept of Surgery, 3635 Vista Ave 3dt, St Louis, MO 63110 | 2020-05-06 |
| 1881232700 | Ashley Diane Pace | Nurse Practitioner | 1 Parkview Place, Shoenberg 6900, St. Louis, MO 63110 | 2019-12-11 |
| 1619520418 | Krithika Damodar Shenoy | Pathology | 660 Euclid Avenue, One Barnes Jewish Hospital Plaza, St. Louis, MO 63110 | 2019-07-20 |
| 1467912550 | Ian Ferguson | Dermatology | 660 S Euclid Ave., Cb 8123, St. Louis, MO 63110 | 2019-03-23 |
| 1760978688 | Ihab Hassanieh | Student in an Organized Health Care Education/Training Program | 33660 Vista Ave, St. Louis, MO 63110 | 2018-07-03 |
| 1336634500 | Martin K Mwangi | Pediatrics | 1 Childrens Place, 3s34, St. Louis, M, MO 63110 | 2018-06-28 |
| Find all providers in zip 63110 | ||||
| Taxonomy Code | 2080P0208X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Infectious Diseases |
| A pediatrician trained to care for children in the diagnosis, treatment and prevention of infectious diseases. This specialist can apply specific knowledge to affect a better outcome for pediatric infections with complicated courses, underlying diseases that predispose to unusual or severe infections, unclear diagnoses, uncommon diseases and complex or investigational treatments. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487781597 | Tessa Gardner | Pediatrics | 7905 Blackberry Ave, Saint Louis, MO 63130-2710 | 2007-02-27 |
| 1295885580 | Edwin Lemuel Anderson | Pediatrics | 1100 S Grand Blvd Fl 1, Saint Louis, MO 63104-1015 | 2007-01-11 |
| 1518274489 | Mercy Clinic Children's Infectious Disease, LLC | Pediatrics | 621 S New Ballas Rd, Suite 674-a, Saint Louis, MO 63141-8232 | 2010-09-13 |
| 1427277110 | St Louis University | Pediatrics | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2007-04-24 |
| 1285656322 | Russell J Osguthorpe | Pediatrics | 1 Childrens Pl, Suite C, Saint Louis, MO 63110-1002 | 2006-07-25 |
| 1730106238 | Patrick C Seed | Pediatrics | 1 Childrens Pl, Suite C, Saint Louis, MO 63110-1002 | 2006-07-17 |
| 1417933433 | Anita Chacko | Pediatrics | 621 S New Ballas Rd, Ste. 674a, Saint Louis, MO 63141-8232 | 2005-12-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184936437 | Liset Carla Olarte Carhuaz | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2010-07-01 |
| 1083849871 | Christelle Marlyse Ilboudo | Pediatrics | 404 N Keene St, Columbia, MO 65201-6626 | 2009-05-21 |
| 1922249739 | Barbara Angelica Pahud | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2009-03-09 |
| 1457507832 | Jennifer Schuster | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2008-08-17 |
| 1013172055 | Rana El Feghaly | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2008-07-18 |
| 1790736510 | Christopher Joseph Harrison | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2006-05-15 |
| 1366493728 | Angela Leigh Myers | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2006-05-12 |
| 1710938188 | Mary Anne Jackson | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2006-05-12 |
| 1326099714 | Douglas Scott Swanson | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2006-05-12 |
| 1154371615 | Denise Bratcher | Pediatrics | 2401 Gillham Rd, Children's Mercy Hospital and Clinics, Kansas City, MO 64108-4619 | 2006-05-12 |
| Find all providers with the same taxonomy | ||||
| City | SAINT LOUIS |
| Zip Code | 63110 |
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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.