Sharrell Tonya Odom, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

18080 Issued in SC

Practice address

755 US Highway 21 S
Ridgeway, SC 29130-6844

Phone

(803) 337-2920

Fax

(803) 337-3010

NPI assigned

Nov 15, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Eau Claire Cooperative Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Columbia, SC
  • NPI 1346249430

  SC

  Medicare reassignment NPD
• Eau Claire Cooperative Health Center ,Inc.

  • Federally Qualified Health Center (FQHC)
  • Columbia, SC
  • NPI 1588375653
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437091200000",
    "number": "1033453048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3788",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292303788",
            "telephone_number": "803-733-5969",
            "fax_number": "803-753-5591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 US HIGHWAY 21 S",
            "city": "RIDGEWAY",
            "state": "SC",
            "postal_code": "291306844",
            "telephone_number": "803-337-2920",
            "fax_number": "803-337-3010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODOM",
        "first_name": "SHARRELL",
        "middle_name": "TONYA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-15",
        "last_updated": "2015-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "18080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP2358",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Marie Hellman, NURSE PRACTITIONER
• Keasia James
• Joshua'S Foundation Inc.
• Christy Monica Kennedy, HHA, MEDICATION TECH
• Nurse Practitioner Solutions, LLC
• Lakeisha T Peay
• Pruitthealth - Ridgeway, LLC
• Jandrette Atayae Rhoe, MD
• Ridgeway Manor Healthcare Center LLC
• Kimberly D Smith, DDS

• All providers in Ridgeway, SC
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.