AMY REBECCA ODOM (NPI# 1750863726) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750863726 |
| Entity Type | Individual |
| Full Name | AMY REBECCA ODOM |
| Credential | NP |
| Practice Address |
100 Memorial Hospital Dr Ste 1a Mobile AL 36608-1128 |
| Mailing Address |
Po Box 7987 Mobile AL 36670-0987 |
| Practice Telephone | 2513436848 |
| Practice Fax Number | 2513435708 |
| Mailing Telephone | 2516330573 |
| Enumeration Date | 2018-09-05 |
| Last Update Date | 2019-06-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
1-140750 | AL | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
1-140750 | AL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | 225084 | 05 | |
| AL | BCBS OF AL | 512-17400 | 01 |
| AL | BCBS OF AL | 512-17403 | 01 |
| AL | RR MEDICARE | P02140037 | 01 |
| AL | VIVA HEALTH | Z54984 | 01 |
| AL | 224261 | 05 | |
| AL | BCBS OF AL | 512-17405 | 01 |
| AL | AETNA | 6297709 | 01 |
| AL | MEDICARE | A03845A | 01 |
| MS | 05331824 | 05 | |
| AL | 223807 | 05 | |
| AL | 225622 | 05 | |
| AL | 225017 | 05 | |
| AL | BCBS OF AL | 512-17404 | 01 |
| AL | BCBS OF AL | 512-17406 | 01 |
| AL | HUMANA CHOICECARE | 630799312 | 01 |
| AL | UNITED HEALTHCARE | 6906123 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2001 Spring Hill Ave, Mobile, AL 366073326 | 2514333344 | 2514334052 |
| 3 Mobile Infirmary Cir Ste 410, Mobile, AL 366073512 | 2514333344 | 2514334052 |
| 5955 Airport Blvd, Mobile, AL 366083135 | 2516330573 | 2516337367 |
| 8725 County Road 64, Daphne, AL 365266061 | 2516251370 | 2516251380 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659882348 | Amy Covington Odom | Registered Nurse | 2124 14th St, Meridian, MS 39301-4040 | 2017-10-20 |
| 1104187541 | Amy Odom | Speech-Language Pathologist | 1829 E Franklin St, Chapel Hill, NC 27514-5861 | 2012-06-01 |
| 1992093702 | Amy N. Odom | Physical Therapist | 2065 Airport Blvd, Suite 300, Pensacola, FL 32504-5931 | 2011-07-13 |
| 1639114739 | Amy J. Odom | Family Medicine | 800 E Columbia St, Mason, MI 48854-1381 | 2006-06-20 |
| Street Address |
100 MEMORIAL HOSPITAL DR STE 1A |
| City | MOBILE |
| State | AL |
| Zip Code | 36608-1128 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760464044 | Lawrence James Sindel | Allergy & Immunology | 100 Memorial Hospital Dr Ste 1a, Mobile, AL 36608 | 2005-11-14 |
| 1265812424 | Brenda Faye Gavin | Nurse Practitioner | 100 Memorial Hospital Dr Ste 1a, Mobile, AL 36608-1128 | 2015-06-03 |
| 1861883225 | Krishna Yvonnne Jefcoat | Nurse Practitioner | 100 Memorial Hospital Dr Ste 1a, Mobile, AL 36608 | 2015-02-06 |
| 1235542713 | Tessie O'quinn | Nurse Practitioner | 100 Memorial Hospital Dr Ste 1a, Mobile, AL 36608-1128 | 2014-06-03 |
| 1932458411 | Brandi Robbins Clayton | Nurse Practitioner | 100 Memorial Hospital Dr Ste 1a, Mobile, AL 36608 | 2012-08-30 |
| 1649581752 | James Alexander Dean II | Internal Medicine | 100 Memorial Hospital Dr Ste 1a, Mobile, AL 36608 | 2010-06-24 |
| 1225126154 | Brian Hinson Sumrall | Internal Medicine | 100 Memorial Hospital Dr Ste 1a, Mobile, AL 36608 | 2006-10-10 |
| 1790877892 | Druhan Lowry Howell | Allergy & Immunology | 100 Memorial Hospital Dr Ste 1a, Mobile, AL 36608 | 2006-09-28 |
| 1467434787 | Randy Gene Dotson | Internal Medicine | 100 Memorial Hospital Dr Ste 1a, Mobile, AL 36608 | 2005-11-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609475524 | Grantham Dental, Inc. | Dentist | 3620 Springhill Memorial Drive South, Mobile, AL 36608 | 2020-10-21 |
| 1114540879 | Dearrius Hines | Home Health Aide | 1370 Lucerne Dr, Mobile, AL 36608 | 2020-05-28 |
| 1558980409 | Rachel Stevens | Registered Nurse | 8507 Tanner Williams Rd, Mobile, AL 36608 | 2020-04-10 |
| 1073170700 | Usa Health Physician Billing Services LLC | Otolaryngology | 5721 Usa Drive North, Hahn 1119, Mobile, AL 36608 | 2019-05-29 |
| 1952885600 | Franklin Primary Health Center Inc. | Dentist | 990 Cody Rd North, Mobile, AL 36608 | 2018-09-19 |
| 1114410040 | Zackary Elkins | Optometrist | 105 W I65 Service Rd N, Mobile, AL 36608 | 2018-06-14 |
| 1023562865 | Covenant Hospice, Inc. | Internal Medicine | 6801 Airport Blvd., Main Tower, 11th Floor North, Mobile, AL 36608 | 2016-08-10 |
| 1730575416 | Rayven Likely | Student in an Organized Health Care Education/Training Program | 1014 Centerwood Dr, Mobile, AL 36608 | 2015-04-09 |
| 1598040461 | Robert S Harlin | Specialist | 75 Clarise Circle, Mobile, AL 36608 | 2011-10-11 |
| 1972884948 | Heidi Michelle Mcdermott | Physical Therapist | 5721 Usa Drive N, Hahn 2050, Mobile, AL 36608 | 2011-09-06 |
| Find all providers in zip 36608 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730720244 | Carl B Regaliza | Nurse Practitioner | 1551 Old Shell Rd, Mobile, AL 36604-1354 | 2019-10-06 |
| 1104471978 | Stephanie Ann Fouts | Nurse Practitioner | 6701 Airport Blvd., B Bldg., T Level, Mobile, AL 36608-3764 | 2019-08-07 |
| 1366004350 | William Augustus Mcmurray Iv | Nurse Practitioner | 2451 University Hospital Dr, Mstn 101, Mobile, AL 36617-2238 | 2019-07-01 |
| 1700343811 | Latricia Deloris Hickenbottom | Nurse Practitioner | 1515 S University Blvd, Mobile, AL 36609-2958 | 2019-02-25 |
| 1508355694 | Deanna Markris | Nurse Practitioner | 1515 S University Blvd, Mobile, AL 36609-2958 | 2018-05-04 |
| 1043748346 | Jennifer Denise Thomas | Nurse Practitioner | 1515 S University Blvd, Mobile, AL 36609-2958 | 2017-05-31 |
| 1922543487 | Denesha Johnson | Nurse Practitioner | 1515 S University Blvd, Mobile, AL 36609-2958 | 2016-12-19 |
| 1922461995 | Alicia Land | Nurse Practitioner | 6701 Airport Blvd, 'b' Bldg., 't' Level, Mobile, AL 36608-6705 | 2016-03-29 |
| 1518329630 | Dorothy Kastrinos | Nurse Practitioner | 1758 Spring Hill Ave, Mobile, AL 36607-3508 | 2016-03-28 |
| 1104216845 | Kathleen J Ferguson | Nurse Practitioner | 75 S University Blvd, Ucom 6000 A, Mobile, AL 36688-0002 | 2015-02-03 |
| Find all providers in MOBILE | ||||
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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.