KALEIGH ODOM (NPI# 1215302484) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215302484 |
| Entity Type | Individual |
| Full Name | KALEIGH ODOM |
| Credential | NP-C |
| Practice Address |
125 Memorial Dr Reidsville GA 30453-4641 |
| Mailing Address |
460 Mall Blvd Ste B Savannah GA 31406-4801 |
| Practice Telephone | 9125573434 |
| Practice Fax Number | 9125576760 |
| Mailing Telephone | 9126445300 |
| Mailing Fax Number | 9126443369 |
| Enumeration Date | 2015-12-14 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
RN223399 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1275 Hammer Sikes Rd, Collins, GA 304217918 | 9122375062 |
| Street Address |
125 MEMORIAL DR |
| City | REIDSVILLE |
| State | GA |
| Zip Code | 30453-4641 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114579331 | Cala Brooke Tanner | Nurse Practitioner | 125 Memorial Dr, Reidsville, GA 30453-4641 | 2019-07-09 |
| 1225273865 | Sherry Richardson May | Nurse Practitioner | 125 Memorial Dr, Reidsville, GA 30453-4641 | 2008-12-11 |
| 1053578666 | The Tattnall Bank | Orthopaedic Surgery | 125 Memorial Dr, Reidsville, GA 30453-4641 | 2008-05-21 |
| 1487799292 | Tattnall Healthcare LLC. | Clinic/Center | 125 Memorial Dr, Reidsville, GA 30453-4641 | 2007-02-20 |
| 1568406437 | Mallory Smith | Emergency Medicine | 125 Memorial Dr, Reidsville, GA 30453-4641 | 2006-06-15 |
| 1356324859 | Benson Wayne Tapley | Family Medicine | 125 Memorial Dr, Reidsville, GA 30453-4641 | 2005-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659990869 | Katrina A Toler | Specialist/Technologist, Other | Optim Medical Center - Tattnall, 247 S Main Street, Reidsville, GA 30453 | 2020-04-09 |
| 1548750110 | Benjamin Addril Clark | Pharmacist | Se Regional Pharmacy Attn: Ben Clark, 300 First Avenue South, Reidsville, GA 30453 | 2018-05-18 |
| 1770824351 | Elite Care Dme,llc | Durable Medical Equipment & Medical Supplies | 123 S. Main St., Reidsville, GA 30453 | 2013-03-07 |
| 1003154766 | Rebekah Hollis Parker | Occupational Therapist | 247 A South Main Street, Reidsville, GA 30453 | 2013-01-30 |
| 1629359419 | D. Wilson Inc. | Durable Medical Equipment & Medical Supplies | 121 South Main Street Unit A, Reidsville, GA 30453 | 2011-09-07 |
| 1417278029 | Tattnall Community Ems | Ambulance | 194 John O Parker Dr., Reidsville, GA 30453 | 2010-06-17 |
| 1518122563 | Brenda Marie Black | Licensed Practical Nurse | 150 Memorial Drive, 150 Memorial Drive, Reidsville, GA 30453 | 2008-07-18 |
| 1063694404 | Ihori Kameyama | Counselor | 150 Memorial Dr., Reidsville, GA 30453 | 2007-11-28 |
| 1710947403 | Donald Franklin Kennedy Jr. | Specialist | 131 Memorial Drive, Reidsville, GA 30453 | 2006-03-25 |
| 1801438676 | Olive Care Durable Medical & Supplies, LLC. | Durable Medical Equipment & Medical Supplies | 123 S. Main St., Reidsville, GA 30453 | 2019-10-14 |
| Find all providers in zip 30453 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316588668 | Komlanvi Sedo Avegno | Nurse Practitioner | 1560 Freeway Dr Ste F, Reidsville, NC 27320-3248 | 2019-10-07 |
| 1376748004 | Carolyn Chaney Hoskins | Nurse Practitioner | 520 Maple Ave Ste B, Reidsville, NC 27320-4600 | 2007-06-21 |
| 1083248470 | Stephanie Matthews | Nurse Practitioner | 217 Turner Dr Ste F, Reidsville, NC 27320-5754 | 2020-02-25 |
| 1497397129 | Pernell Dean Nance | Nurse Practitioner | 217 Turner Dr Ste F, Reidsville, NC 27320-5754 | 2019-10-15 |
| 1659922722 | Carol Ann Alexander | Nurse Practitioner | 247 S Main St, Reidsville, GA 30453-4605 | 2019-09-20 |
| 1114579331 | Cala Brooke Tanner | Nurse Practitioner | 125 Memorial Dr, Reidsville, GA 30453-4641 | 2019-07-09 |
| 1457866451 | Tenika Chique Mccorkle | Nurse Practitioner | 1123 S Main St, Ste C, Reidsville, NC 27320-5340 | 2017-12-13 |
| 1598896680 | Barbie Jenine Carpenter | Nurse Practitioner | 247 S Main St, Reidsville, GA 30453-4605 | 2007-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780285486 | Aprn Mobile Clinic LLC | Nurse Practitioner | 1361 Highwoods Pass, Grovetown, GA 30813-3994 | 2020-11-08 |
| 1093316820 | Odyne Rose Lacossiere-dorvilus | Nurse Practitioner | 30 Myrtlewood Dr, Savannah, GA 31405-1024 | 2020-11-06 |
| 1104427061 | Tya Wright | Nurse Practitioner | 1450 Newnan Crossing Blvd E Apt 13205, Newnan, GA 30265-0027 | 2020-11-05 |
| 1235730409 | Cheryl Lynn Williams | Nurse Practitioner | 282 Somerset Dr, Dallas, GA 30132-9761 | 2020-11-04 |
| 1033710298 | Karen F Frazier | Nurse Practitioner | 6610 Crest Wood Ln, Douglasville, GA 30135-9046 | 2020-11-04 |
| 1619578986 | Marjorie Sewannyana | Nurse Practitioner | 553 Camano Way, Mcdonough, GA 30253-8377 | 2020-11-03 |
| 1639770027 | Markesha Leshea Groomes | Nurse Practitioner | 209 N. Cuthbert, Colquitt, GA 39837-3515 | 2020-11-03 |
| 1265033625 | Ashley Thomas | Nurse Practitioner | 3750 Venture Dr Ste E4, Duluth, GA 30096-1863 | 2020-11-03 |
| 1558962894 | Anna Marie Kodama | Nurse Practitioner | 462 Furys Ferry Rd # C, Augusta, GA 30907-9506 | 2020-11-03 |
| 1093315848 | Tracy Tarvers | Nurse Practitioner | 129 Wolf Creek Dr N, Macon, GA 31210-9002 | 2020-10-30 |
| Find all providers with the same taxonomy | ||||
| City | REIDSVILLE |
| Zip Code | 30453 |
Please comment or provide details below to improve the information on KALEIGH ODOM.
| 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.