DR. ANGELA D ODOM-AUSTIN (NPI# 1437180072) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437180072 |
| Entity Type | Individual |
| Full Name | DR. ANGELA D ODOM-AUSTIN |
| Credential | M.D. |
| Practice Address |
1140 S Vienna St Ruston LA 71270-5834 |
| Mailing Address |
Po Box 1230 Hampton VA 23661-0230 |
| Practice Telephone | 3182247190 |
| Mailing Telephone | 7572471111 |
| Mailing Fax Number | 7578255740 |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2019-10-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
0101047120 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 6754406 | 05 | |
| LA | 2505637 | 05 |
| Street Address |
1140 S VIENNA ST |
| City | RUSTON |
| State | LA |
| Zip Code | 71270-5834 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033738240 | Winn Community Health Center, Inc. | Pharmacy | 1140 S Vienna St, Ruston, LA 71270-5834 | 2020-04-09 |
| 1710549639 | Melani Craig | Nurse Practitioner | 1140 S Vienna St, Ruston, LA 71270-5834 | 2019-07-01 |
| 1477090959 | Winn Community Health Center, Inc. | Social Worker | 1140 S Vienna St, Ruston, LA 71270-5834 | 2017-01-23 |
| 1730468083 | Wynne Dee Rinicker | Nurse Practitioner | 1140 S Vienna St, Ruston, LA 71270-5834 | 2011-08-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144821315 | Olivia Mason | Marriage & Family Therapist | 413 North Homer Street, Ruston, LA 71270 | 2020-11-04 |
| 1972146132 | Razz Addiction and Recovery, LLC | Family Medicine | 570 Heard Rd, Ruston, LA 71270 | 2019-10-21 |
| 1518435999 | Tenia Holloway | Case Manager/Care Coordinator | 612 Henderson St., F12, Ruston, LA 71270 | 2018-11-05 |
| 1245708718 | A Plus Medical of Ruston LLC | Family Medicine | 612 S Farmerville Street, Ruston, LA 71270 | 2018-11-02 |
| 1255808085 | Amanda M Clark | Specialist/Technologist | 2301 Timberline Ct Apt F105, Ruston, LA 71270 | 2018-10-30 |
| 1912473752 | Lincoln Nova Vital Recovery | Counselor | 4396 Hwy, 80, 617 South Trention, Ruston, LA 71270 | 2018-10-19 |
| 1861975237 | Wymeka Andrea Breaux | Case Manager/Care Coordinator | 705 Martin Luther King Dr., Ruston, LA 71270 | 2018-09-12 |
| 1790292001 | Louquyhanta Foster | Case Manager/Care Coordinator | 593 Belton Rd, Ruston, LA 71270 | 2018-01-08 |
| 1609391010 | Chemia Herron | Counselor | 775 S Bonner, Ruston, LA 71270 | 2017-08-07 |
| 1477083517 | Arnesha Beard | Counselor | 775 South Bonner, Ruston, LA 71270 | 2017-06-12 |
| Find all providers in zip 71270 | ||||
| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962970582 | Total Health Family Medicine | Pediatrics | 9435 Mansfield Rd Ste 5b, Shreveport, LA 71118-3859 | 2018-11-13 |
| 1558571893 | Sarah Elizabeth Wheat | Pediatrics | 2551 Greenwood Rd., Suite 310, Shreveport, LA 71103 | 2007-05-23 |
| 1992925614 | John E Daigre Jr. | Pediatrics | 315 N Demanade Blvd, Lafayette, LA 70503-2555 | 2007-04-26 |
| 1811017882 | Barry Stephen Bordenave | Pediatrics | 321 Overhill Dr, Lake Charles, LA 70605-6527 | 2007-03-30 |
| 1174691034 | Linda Ann Doughty White | Pediatrics | 4511 Downman Rd, New Orleans, LA 70126-3716 | 2006-11-30 |
| 1780763946 | Alfredo Oscar Lebron | Pediatrics | 3220 Kaliste Saloom Rd, Lafayette, LA 70508 | 2006-11-06 |
| 1316030851 | Stephanie Catherine Arnaud | Pediatrics | 515 Westbank Expressway, Suite 1, Gretna, LA 70053 | 2006-10-02 |
| 1306945399 | Cecily Joan Poree-turner | Pediatrics | 4052 Ulloa St, New Orleans, LA 70119-6834 | 2006-09-22 |
| 1952401705 | Child Health America Physician Group | Pediatrics | 3324 Florida Blvd, Baton Rouge, LA 70806 | 2006-09-22 |
| 1720195290 | Dana Angelle Fakouri | Pediatrics | 8040 Goodwood Blvd, Baton Rouge, LA 70806-7631 | 2006-08-23 |
| 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.