MICHAEL STEPHEN ODOM (NPI# 1093197980) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093197980 |
| Entity Type | Individual |
| Full Name | MICHAEL STEPHEN ODOM |
| Credential | M.D. |
| Practice Address |
103 Whitetail Dr Walhalla SC 29691 |
| Mailing Address |
Po Box 262 Anderson SC 29622-0262 |
| Practice Telephone | 8646383444 |
| Mailing Telephone | 8645122830 |
| Mailing Fax Number | 8645122379 |
| Enumeration Date | 2015-06-26 |
| Last Update Date | 2018-09-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 38156 | SC | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2000 E Greenville St, Anderson, SC 296211580 | 8645121000 | 8645121823 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205245552 | Michael Odom Jr. | Physical Therapist | 2430 Charles Blvd, Greenville, NC 27858-5924 | 2014-08-11 |
| 1366780538 | Michael Odom | Case Manager/Care Coordinator | 1500 E Kay St, Compton, CA 90221-1752 | 2013-01-23 |
| 1700175536 | Michael Ryan Odom | Family Medicine | 9300 Dewitt Loop, Ft Belvoir, VA 22060-5285 | 2011-04-01 |
| 1386655298 | Michael Odom | Pediatrics | 7703 Floyd Curl Dr, Mc 7977, San Antonio, TX 78229-3901 | 2006-08-10 |
| Street Address |
103 WHITETAIL DR |
| City | WALHALLA |
| State | SC |
| Zip Code | 29691 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699759217 | William Strother Darby | Family Medicine | 103 Whitetail Dr, Walhalla, SC 29691-5837 | 2005-12-06 |
| 1043857998 | Prisma Health-upstate | Clinic/Center | 103 Whitetail Dr, Walhalla, SC 29691-5837 | 2019-12-10 |
| 1902351190 | Keri Marlene Dickson | Nurse Practitioner | 103 Whitetail Dr, Walhalla, SC 29691-5837 | 2016-08-17 |
| 1669820726 | Sherri Mcmahan | Nurse Practitioner | 103 Whitetail Dr, Walhalla, SC 29691-5837 | 2016-05-31 |
| 1881057644 | Britta Ann Johnson | Nurse Practitioner | 103 Whitetail Dr, Walhalla, SC 29691-5837 | 2016-03-30 |
| 1154703783 | Sarah Caroline Fabry | Family Medicine | 103 Whitetail Dr, Walhalla, SC 29691 | 2015-06-19 |
| 1467891895 | Ronni Ayala | Nurse Practitioner | 103 Whitetail Dr, Walhalla, SC 29691-5837 | 2013-06-19 |
| 1366530768 | Teresa Lynn Brown | Family Medicine | 103 Whitetail Dr, Walhalla, SC 29691-5837 | 2006-10-11 |
| 1770519209 | Susan H Curtis | Nurse Practitioner | 103 Whitetail Dr, Walhalla, SC 29691-5837 | 2006-06-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598970097 | Steven Syck | Rehabilitation Hospital | 112 Falcons View Ct., Walhalla, SC 29691 | 2007-05-10 |
| 1710093281 | Sidney R Bryson Dmd Pa | Dentist | 107 N Earle St, Walhalla, SC 29691 | 2006-08-21 |
| 1578515649 | School District of Oconee County | Local Education Agency (LEA) | 414 S Pine St, Walhalla, SC 29691 | 2006-05-17 |
| 1295782290 | Robert Edward Lawson Iv | Chiropractor | 206 W Main St, Walhalla, SC 29691 | 2006-05-27 |
| 1770995953 | Linda Smith | Licensed Practical Nurse | 151 Razorback Ln, Walhalla, SC 29691-1624 | 2014-05-22 |
| 1245676824 | Alison Crocker Chiles | Registered Nurse | 177 Razorback Ln, Walhalla, SC 29691-1624 | 2013-05-22 |
| 1669810388 | Pearl Reese | Licensed Practical Nurse | 225 Coffee Rd, 225 Coffee Road, Walhalla, SC 29691-1777 | 2013-06-05 |
| 1508482555 | Maria Kraayeveld | Speech-Language Pathologist | 225 Coffee Rd, Walhalla, SC 29691-1777 | 2020-06-24 |
| 1063930782 | Opal Anna Farwell | Speech-Language Pathologist | 225 Coffee Rd, Walhalla, SC 29691-1777 | 2017-09-01 |
| 1942609854 | Laurie Vanderwiele | Speech-Language Pathologist | 225 Coffee Rd, Walhalla, SC 29691-1777 | 2014-08-15 |
| Find all providers in zip 29691 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861502890 | Good Shepherd Family Practice, Pa | Family Medicine | 111 N Earle St, Walhalla, SC 29691-2419 | 2006-08-31 |
| 1699759217 | William Strother Darby | Family Medicine | 103 Whitetail Dr, Walhalla, SC 29691-5837 | 2005-12-06 |
| 1154703783 | Sarah Caroline Fabry | Family Medicine | 103 Whitetail Dr, Walhalla, SC 29691 | 2015-06-19 |
| 1366530768 | Teresa Lynn Brown | Family Medicine | 103 Whitetail Dr, Walhalla, SC 29691-5837 | 2006-10-11 |
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| 1063024578 | Beaufort County Memorial Hospital | Family Medicine | Beaufort Memorial Preoperative Assessment Clinic, 989 Ribaut Road Suite 370, Beaufort, SC 29902 | 2020-08-18 |
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| 1922617950 | Fred E Hill | Family Medicine | 1033 Jervey Point Rd, Charleston, SC 29492-8372 | 2020-07-27 |
| Find all providers with the same taxonomy | ||||
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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.