BRETT C ODUM (NPI# 1336143163) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336143163 |
| Entity Type | Individual |
| Full Name | BRETT C ODUM |
| Credential | MD |
| Practice Address |
240 Medical Park Blvd Ste 3600 Bristol TN 37620-7346 |
| Mailing Address |
Po Box 9 Kingsport TN 37662-0009 |
| Practice Telephone | 4239902400 |
| Practice Fax Number | 4239902405 |
| Mailing Telephone | 4238572066 |
| Mailing Fax Number | 4238572070 |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2011-08-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | MD 37808 | TN | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 0101232193 | VA | Allopathic & Osteopathic Physicians |
| N | 208M00000X | Hospitalist | 37808 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3888335 | 05 |
| Street Address |
240 MEDICAL PARK BLVD STE 3600 |
| City | BRISTOL |
| State | TN |
| Zip Code | 37620-7346 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558364620 | Tammy Monk | Nurse Practitioner | 240 Medical Park Blvd, Ste 3600, Bristol, TN 37620-7346 | 2005-05-23 |
| 1295381895 | Taylor White | Specialist/Technologist | 240 Medical Park Blvd, Bristol, TN 37620-7346 | 2019-08-11 |
| 1295176196 | Sarah Ann Ferguson | Nurse Practitioner | 240 Medical Park Blvd, Ste 3600, Bristol, TN 37620-7346 | 2013-07-09 |
| 1164765871 | Cassie Brooks Hudson | Pediatrics | 240 Medical Park Blvd, Ste 3600, Bristol, TN 37620-7346 | 2013-04-01 |
| 1598008542 | Jennifer Phemister | Internal Medicine | 240 Medical Park Blvd, Bristol, TN 37620-7346 | 2013-03-28 |
| 1518253392 | Jamie Weaver Lowe | Audiologist | 240 Medical Park Blvd, Ste 1000, Bristol, TN 37620-7346 | 2011-06-21 |
| 1821301573 | Jessica Lynn Kennedy | Physical Therapist | 240 Medical Park Blvd, Ste 1700, Bristol, TN 37620-7346 | 2010-07-23 |
| 1295053759 | Ryan Christopher Kennedy | Internal Medicine | 240 Medical Park Blvd, Ste 3800, Bristol, TN 37620-7346 | 2010-05-08 |
| 1184940462 | Trusha Patel | Internal Medicine | 240 Medical Park Blvd, Ste 3800, Bristol, TN 37620-7346 | 2010-04-12 |
| 1508091034 | Emily O. Campbell | Family Medicine | 240 Medical Park Blvd, Ste 3600, Bristol, TN 37620-7346 | 2009-05-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376180216 | Firstep, LLC | Psychiatry & Neurology | 3183 W. State St., Suite 1201, Bristol, TN 37620 | 2019-12-10 |
| 1578047726 | Amanda Harville Mcgrady | Psychologist | 105 Walnut Circle, Bristol, TN 37620 | 2018-09-23 |
| 1467932533 | Teresa Mooney | Nurse Practitioner | 324 Leslie Ct, Bristol, TN 37620 | 2018-08-17 |
| 1992285308 | Jeremy Aurbrey Blanzy | Nurse Practitioner | 1 Medical Park Boulevard, Suite 400e, Bristol, TN 37620 | 2018-08-15 |
| 1255841805 | Amanda L Pillion | Audiologist | 225 Midway Medical Park, Bristol, VA 37620 | 2017-10-10 |
| 1841717717 | Joel Blevins | Driver | 301 Webb Ct, Bristol, TN 37620 | 2017-08-23 |
| 1831579796 | Dr. Marie Crawford, Ph.d., Pllc | Psychologist | 739 Bluff City Highway, Suite 5, Bristol, TN 37620 | 2015-06-05 |
| 1508297169 | Cassandra Marie Conry | Chiropractor | 800 Hill St., Bristol, TN 37620 | 2013-12-09 |
| 1780025874 | Laura Leann Lawson-renfro | Nurse Practitioner | 260 Midway St, Bristol, TN 37620 | 2013-07-17 |
| 1760822365 | Ricky Bhimani | Internal Medicine | 208 Medical Park Boulevard, Bristol, TN 37620 | 2013-06-27 |
| Find all providers in zip 37620 | ||||
| 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 |
|---|---|---|---|---|
| 1871840843 | Five-town Health Alliance, Inc | Family Medicine | 61 Pine Street, Building 4, Bristol, VT 05443 | 2012-08-09 |
| 1417214537 | Leonard Davidson | Family Medicine | 202 Jefferson Ave, Bristol, PA 19007 | 2012-04-13 |
| 1760758734 | Renee Bratspis | Family Medicine | 74 Munsill Ave Ste 100, Bristol, VT 05443-1047 | 2012-03-23 |
| 1013288810 | Medical Education Assistance Corporation | Family Medicine | 826 Meadow View Rd, Bristol, TN 37620 | 2012-01-25 |
| 1780829572 | David Lynn Stevens | Family Medicine | 504 Old Jonesboro Rd, Bristol, TN 37620-5670 | 2008-12-08 |
| 1285892299 | Natasha Alexa Withers | Family Medicine | 61 Pine St Ste 400, Bristol, VT 05443-1043 | 2008-05-27 |
| 1992901409 | Uzoma N Obuekwe | Family Medicine | 2001 Euclid Ave, Bristol, VA 24201-3609 | 2007-06-22 |
| 1750502514 | Ronna Denise New | Family Medicine | 1 Medical Park Blvd Ste 450w, Bristol, TN 37620-7470 | 2007-05-01 |
| 1063552461 | Carol A Dewey | Family Medicine | 522 Alabama St, Bristol, TN 37620-2307 | 2007-02-07 |
| 1093898702 | J Scott Ries | Family Medicine | 504 Old Jonesboro Road, Bristol, TN 37620 | 2006-10-24 |
| Find all providers in BRISTOL | ||||
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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.