MRS. ELIZABETH BOYD ODOM (NPI# 1700190832) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700190832 |
| Entity Type | Individual |
| Full Name | MRS. ELIZABETH BOYD ODOM |
| Credential | RD, LDN |
| Practice Address |
19 North Dobbs Street Halifax NC 27839-0010 |
| Practice Telephone | 2525835021 |
| Practice Fax Number | 2525832975 |
| Mailing Telephone | 2525835021 |
| Mailing Fax Number | 2525832975 |
| Enumeration Date | 2010-07-30 |
| Last Update Date | 2014-04-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 133N00000X | Nutritionist | L001680 | NC | Dietary & Nutritional Service Providers |
| Y | 133VN1006X |
Dietitian, Registered Specialization: Nutrition, Metabolic |
843319 | NC | Dietary & Nutritional Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 6005545 | 05 | |
| NC | 340432 | 05 | |
| NC | 3404433 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669773636 | Elizabeth Ann Odom | Counselor | 213 E 2nd St, Fairmont, MN 56031-2814 | 2010-11-08 |
| 1295297158 | Elizabeth Kirby Odom | Student in an Organized Health Care Education/Training Program | 1184 5th Ave Fl 8, New York, NY 10029-6503 | 2019-04-01 |
| 1548767882 | Elizabeth Hyde Odom | Counselor | 4388 Katella Ave, Los Alamitos, CA 90720 | 2018-04-12 |
| 1831693480 | Elizabeth Odom | Physical Therapy Assistant | 1245 Church Rd, Wyncote, PA 19095-1800 | 2018-03-20 |
| 1780970566 | Elizabeth Burkhart Odom | Surgery | 660 S Euclid Ave, Box 8109, Saint Louis, MO 63110-1010 | 2011-06-21 |
| Street Address |
19 NORTH DOBBS STREET |
| City | HALIFAX |
| State | NC |
| Zip Code | 27839-0010 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740217785 | County of Halifax | Public Health or Welfare | 19 North Dobbs Street, Halifax, NC 27839-0010 | 2006-06-26 |
| 1821122565 | Janice Tillery Myrick | Nurse Practitioner | 19 North Dobbs Street, Halifax, NC 27839-0010 | 2007-03-15 |
| 1992865620 | Diane Rokita Pridgen | Counselor | 19 North Dobbs Street, Halifax, NC 27839-0010 | 2006-12-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366656464 | Halifax County Department of Social Services | Community/Behavioral Health | 4421 Highway 301, Halifax, NC 27839 | 2007-05-09 |
| 1538366810 | Halifax County Department of Social Services | Community/Behavioral Health | 4421 Highway 301, Halifax, NC 27839 | 2007-06-29 |
| 1124303722 | Halifax County Health Department | Dietitian, Registered | 19 North Dobbs St., Halifax, NC 27839-0010 | 2011-10-14 |
| 1003843608 | Solomon Shapiro | Family Medicine | 19 N. Dobbs Street, Halifax, NC 27839-0010 | 2006-06-27 |
| 1942434923 | Brandi N Ross | Physical Therapy Assistant | 63 S. Bradley Drive, Halifax, NC 27839-0435 | 2009-05-06 |
| 1942354303 | Life, Inc. | Intermediate Care Facility, Mentally Retarded | 117 South King Street, Halifax, NC 27839-0446 | 2007-01-23 |
| 1790803864 | Halifax County Schools | Local Education Agency (LEA) | 9525 Hwy 301 South, Halifax, NC 27839-0468 | 2007-03-27 |
| 1639517683 | Wescare Professional Services, LLC. | Community/Behavioral Health | 196 Old 125 Rd, Halifax, NC 27839-8776 | 2013-06-12 |
| 1700217056 | Rural Health Group, Inc. | Clinic/Center | 4489 Us Highway 301, Halifax, NC 27839-9510 | 2013-12-11 |
| Taxonomy Code | 133VN1006X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| Specialization | Nutrition, Metabolic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124303722 | Halifax County Health Department | Dietitian, Registered | 19 North Dobbs St., Halifax, NC 27839-0010 | 2011-10-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649662982 | Thomas Rodgers Jr. | Dietitian, Registered | 4105 Lawndale Pl, Greensboro, NC 27455-1637 | 2015-02-24 |
| 1306243399 | Natalie Dickinson | Dietitian, Registered | 225 Haw Creek Mews Dr, Asheville, NC 28805-1966 | 2014-11-19 |
| 1386932739 | Doris Fiorillo Wicks | Dietitian, Registered | 19220 Makayla Ln, Cornelius, NC 28031-6527 | 2011-07-19 |
| 1568626109 | Jane E. Stegner | Dietitian, Registered | 2393 Jefferson Ave, Winston Salem, NC 27103-4315 | 2008-07-14 |
| 1801079298 | Michelle Lila Blitstein | Dietitian, Registered | 4812 Carmel Park Dr, Charlotte, NC 28226-5131 | 2007-12-09 |
| 1780895136 | Sherrie Fennell Edwards | Dietitian, Registered | 1500 Lanely Ave., Seymour Johnson Afb, Golsboro, NC 27534 | 2007-05-25 |
| 1053339952 | Nalini Narahari | Dietitian, Registered | 202 Bradwyck Dr, Cary, NC 27513-9414 | 2006-07-18 |
| 1043278195 | Integrative Therapies, Inc. | Dietitian, Registered | 7 E Oak Branch Dr, Greensboro, NC 27407 | 2006-05-01 |
| 1295386001 | Be Nutrition LLC | Dietitian, Registered | 4651 Charlotte Park Dr Ste 101c, Charlotte, NC 28217-1916 | 2019-09-23 |
| 1821577040 | Sarah E Novelly Rush | Dietitian, Registered | 114 Charlois Blvd, Winston Salem, NC 27103-1522 | 2018-08-08 |
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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.