JENNIFER J ODOM (NPI# 1538501879) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538501879 |
| Entity Type | Individual |
| Full Name | JENNIFER J ODOM |
| Credential | PA |
| Practice Address |
1350 Hickory St Melbourne FL 32901-3224 |
| Mailing Address |
3300 S Fiske Blvd Rockledge FL 32955-4306 |
| Practice Telephone | 3214341771 |
| Practice Fax Number | 3214341775 |
| Mailing Telephone | (321) 434-1771 |
| Mailing Fax Number | 3214341775 |
| Enumeration Date | 2013-07-29 |
| Last Update Date | 2017-08-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA9106958 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477181295 | Jennifer Lauren Odom | Physical Therapist | 915 W Exchange Pkwy Ste 100, Allen, TX 75013-7018 | 2020-03-28 |
| 1649829938 | Jennifer Odom | Licensed Vocational Nurse | 7710 W Interstate 10, San Antonio, TX 78230-4711 | 2019-09-09 |
| 1255761938 | Jennifer Nicole Odom | Registered Nurse | 1613 N Mckenzie St, Foley, AL 36535-2247 | 2013-11-18 |
| 1689940090 | Jennifer Spencer Odom | Counselor | 4031 W Plano Pkwy, Plano, TX 75093-5619 | 2012-03-29 |
| 1033232251 | Jennifer Perry Odom | Social Worker | 120 N Abington Rd, Clarks Green, PA 18411-2541 | 2007-04-10 |
| Street Address |
1350 HICKORY ST |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32901-3224 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437159670 | Igor Balatsky | Internal Medicine | 1350 Hickory St, Hrmc/hospitalist Program, Melbourne, FL 32901-3224 | 2005-07-29 |
| 1346855301 | Anushree Patel | Anesthesiologist Assistant | 1350 Hickory St, Melbourne, FL 32901-3224 | 2020-09-15 |
| 1316565492 | Megan Bellinger | Dietitian, Registered | 1350 Hickory St, Melbourne, FL 32901-3224 | 2020-07-06 |
| 1427673011 | Jessica Joy Milnor | Nurse Anesthetist, Certified Registered | 1350 Hickory St, Melbourne, FL 32901-3278 | 2020-06-10 |
| 1487274205 | Eric Cuthbert | Registered Nurse | 1350 Hickory St, Melbourne, FL 32901-3224 | 2020-04-22 |
| 1366061970 | Lisa Kistler | Pharmacist | 1350 Hickory St, Melbourne, FL 32901-3278 | 2020-04-14 |
| 1194344168 | Tracy Eichelberger | Respiratory Therapist, Registered | 1350 Hickory St, Melbourne, FL 32901-3278 | 2020-04-10 |
| 1477198752 | Matthew Robert Ferraro | Pharmacist | 1350 Hickory St, Melbourne, FL 32901-3224 | 2019-11-11 |
| 1356983092 | Parvin Deidri Daneshvar | Registered Nurse | 1350 Hickory St, Melbourne, FL 32901-3224 | 2019-10-15 |
| 1972155489 | David Nester Lucas | Family Medicine | 1350 Hickory St, Melbourne, FL 32901-3224 | 2019-07-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467062943 | George Pappas | Anesthesiologist Assistant | 1775 W. Hibiscus Blvd., Ste 215, Melbourne, FL 32901 | 2020-08-09 |
| 1124676820 | Abbi Dell Lee | Behavioral Analyst | 3251 Engineering St, Melbourne, FL 32901 | 2019-08-27 |
| 1750856878 | Jeffrey Michael Cavanagh | Behavior Technician | 3251 Engineering Street, Melbourne, FL 32901 | 2018-10-04 |
| 1740766021 | Amanda Miller | Behavior Technician | 1885 W Hibiscus Blvd, Melbourne, FL 32901 | 2018-07-19 |
| 1396244406 | Dragen II LLC | Urology | 129 W Hibiscus Blvd Ste D, Melbourne, FL 32901 | 2018-02-03 |
| 1225550692 | Cabrit Psychotherapy Services LLC | Marriage & Family Therapist | 100 Rialto Place, Suite 700, Melbourne, FL 32901 | 2017-07-07 |
| 1487188058 | Project Response, Inc. | Clinic/Center | 747 S. Apollo Boulevard, Melbourne, FL 32901 | 2017-04-20 |
| 1184174575 | Paulette Swanson | Physical Therapist | 611 East Sheridan Rd, Melbourne, FL 32901 | 2016-10-10 |
| 1841747839 | Nicholas Wilson | Social Worker | 3661 S. Babcock St., Melbourne, FL 32901 | 2016-09-07 |
| 1467804278 | Nickolas Hetherington | Occupational Therapist | 1900 S Harbor City Blvd Ste 108, Melbourne, FL 32901 | 2016-07-05 |
| Find all providers in zip 32901 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093263873 | Kaitlin Lassen | Physician Assistant | 8057 Spyglass Hill Rd Ste 104, Melbourne, FL 32940-8565 | 2016-09-21 |
| 1386815835 | Jessica L Boudreaux-milligan | Physician Assistant | 2290 W Eau Gallie Blvd Ste 210b, Melbourne, FL 32935 | 2008-03-12 |
| 1013106376 | Sabrina Wu Staples | Physician Assistant | 3337 Hoofprint Dr, Melbourne, FL 32940-2304 | 2007-10-23 |
| 1528032547 | David A Harris | Physician Assistant | 1341 Medical Park Dr Ste 201, Melbourne, FL 32901 | 2006-02-15 |
| 1023094414 | Patrick Gene Campbell | Physician Assistant | 1494 Avocado Ave, Melbourne, FL 32935-6532 | 2005-12-19 |
| 1184618233 | George David Mccullough | Physician Assistant | 1051 S Hickory St, Ste A, Melbourne, FL 32901-1962 | 2005-09-06 |
| 1255877981 | Michael Paul Teepe | Physician Assistant | 1341 Medical Park Dr Ste 201, Melbourne, FL 32901-3235 | 2017-01-19 |
| 1336597137 | Barbara Suzanne Coleman | Physician Assistant | 1341 Medical Park Dr Ste 201, Melbourne, FL 32901-3235 | 2016-06-02 |
| 1144687534 | Alexis Best | Physician Assistant | 1223 Gateway Dr Ste 1e, Melbourne, FL 32901-2607 | 2016-01-15 |
| 1346662103 | Casey W Langel | Physician Assistant | 2222 S Harbor City Blvd, Suite 610, Melbourne, FL 32901-5594 | 2014-01-14 |
| Find all providers in MELBOURNE | ||||
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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.