MRS. LEANNE ODOM (NPI# 1245429687) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245429687 |
| Entity Type | Individual |
| Full Name | MRS. LEANNE ODOM |
| Credential | PA-C |
| Practice Address |
4802 S 109th East Ave Tulsa OK 74146-5822 |
| Practice Telephone | 9183921400 |
| Practice Fax Number | 9183921488 |
| Mailing Telephone | 9183921400 |
| Mailing Fax Number | 9183921488 |
| Enumeration Date | 2007-10-22 |
| Last Update Date | 2007-10-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
1672 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4802 S 109TH EAST AVE |
| City | TULSA |
| State | OK |
| Zip Code | 74146-5822 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275500415 | Jaafar M Bazih | Orthopaedic Surgery | 4802 S 109th East Ave, Tulsa, OK 74146-5822 | 2006-03-07 |
| 1285294710 | Tbj Advanced Care LLC | Orthopaedic Surgery | 4802 S 109th East Ave, Tulsa, OK 74146-5822 | 2019-06-17 |
| 1003391905 | Rebecca Holland | Physician Assistant | 4802 S 109th East Ave, Tulsa, OK 74146-5822 | 2018-09-27 |
| 1730685314 | Johnathon David Millwee | Specialist/Technologist | 4802 S 109th East Ave, Tulsa, OK 74146 | 2018-04-03 |
| 1124400064 | Craig Stewart | Physical Therapist | 4802 S 109th East Ave, Tulsa, OK 74146-5822 | 2015-06-28 |
| 1396155222 | Rey Amezquita | Orthotist | 4802 S 109th East Ave, Brace Shop, Tulsa, OK 74146-5822 | 2014-04-30 |
| 1700223070 | Thomas Calvin Blair IIi | Physical Therapist | 4802 S 109th East Ave, Tulsa, OK 74146-5822 | 2013-05-28 |
| 1396082137 | Ashley Linn Legg | Physician Assistant | 4802 S 109th East Ave, Tulsa, OK 74146-5822 | 2013-01-14 |
| 1417251372 | Luis Hernandez | Physician Assistant | 4802 S 109th East Ave, Tulsa, OK 74146-5822 | 2011-01-06 |
| 1720306277 | Jason Griffin | Orthopaedic Surgery | 4802 S 109th East Ave, Tulsa, OK 74146-5822 | 2010-05-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922624550 | Sage Anesthesia Services Inc. | Nurse Anesthetist, Certified Registered | Union Pines Surgery Center, 4808 S 109th E Ave, Tulsa, OK 74146 | 2020-06-19 |
| 1811401631 | Fresenius Medical Care Tulsa, LLC | Clinic/Center | 5230 S Mingo Rd, Tulsa, OK 74146 | 2017-12-01 |
| 1184158404 | Alexis Lauren Allen | Case Manager/Care Coordinator | 9820 E 41st St #400, Tulsa, OK 74146 | 2017-04-13 |
| 1578995908 | Adrian Gheorghe Butuc | Massage Therapist | 5635 S Mingo #b, Tulsa, OK 74146 | 2013-08-08 |
| 1336587088 | Tulsa Cancer Institute, Pllc | Obstetrics & Gynecology | 12697 E. 51st St. South, Tulsa, OK 74146 | 2013-06-04 |
| 1265782338 | Milestones Pediatric Urgent Care | Pediatrics | 3863 South 103rd E Avenue, Tulsa, OK 74146 | 2012-09-14 |
| 1619232972 | Diagnostic Imaging Associates | General Acute Care Hospital | 4500 S Garnett Rd, Ste 300, Tulsa, OK 74146 | 2012-07-11 |
| 1790046654 | Aundra Lamar Fuller | Behavioral Analyst | 10922 E. 39th St., Tulsa, OK 74146 | 2012-06-06 |
| 1134492416 | Mark S Thomas Jr. | Behavioral Analyst | 10005 E 52nd Street, Tulsa, OK 74146 | 2012-02-16 |
| 1922307958 | Founders Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 5115 S. 122nd East Ave., Suite 204, Tulsa, OK 74146 | 2011-03-16 |
| Find all providers in zip 74146 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073154647 | Haley Nicole Beaird | Physician Assistant | 8907 E 93rd St, Tulsa, OK 74133-5634 | 2019-10-03 |
| 1790155562 | Caldwell Medical Group of North Tulsa LLC | Physician Assistant | 8014 S 101st East Ave, Tulsa, OK 74133-4579 | 2015-10-05 |
| 1609298330 | Marci Love Deck | Physician Assistant | 2000 S Wheeling Ave Ste 1000, Tulsa, OK 74104-5648 | 2014-01-15 |
| 1619216272 | Nicole Lisette Mancinelli | Physician Assistant | 2424 E. 21st Street, Suite 320, Tulsa, OK 74114 | 2013-02-01 |
| 1184959389 | Erin Nicole Jones | Physician Assistant | 11212 E 48th St., Oklahoma Oncology, Tulsa, OK 74146-5806 | 2009-10-06 |
| 1194901793 | Annamae Kay | Physician Assistant | 1919 South Wheeling Ave, Ste 304, Tulsa, OK 74104 | 2008-01-14 |
| 1265632129 | Oklahoma Occupational Health Center | Physician Assistant | 5640 S Memorial Dr, Tulsa, OK 74145-9001 | 2007-07-19 |
| 1962535831 | Njanja Margaret Ruenji | Physician Assistant | Morton Comprehensive Health Services, 1334 N. Lasing Ave, Tulsa, OK 74106-5907 | 2007-03-13 |
| 1740355460 | Jeri Clark Goen | Physician Assistant | 3807 S Peoria Ave, Suite G and H, Tulsa, OK 74105-3145 | 2006-11-21 |
| 1790879237 | Steven Paul Henry | Physician Assistant | 10506 South Memorial Drive, Tulsa, OK 74133 | 2006-10-02 |
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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.