Carla Odom

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

904705 Issued in MS

Practice address

963 Taylor Rd
Kokomo, MS 39643-4967

Phone

(601) 303-0050

NPI assigned

Sep 24, 2020

Last updated

Feb 25, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Blackwells Family Medicine LLCGroup PAC ID 0749616381, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Luke Home Health Services Home health agency, McComb, MS, CCN 257124
• Walthall County General Hospital Cah Hospital, Tylertown, MS, CCN 251324
• Southwest Ms Regional Medical Center Hospital, McComb, MS, CCN 250097
• Marion General Hospital Hospital, Columbia, MS, CCN 250085

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: carla.odom.1@20592.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/20592/brand/1/csg/1/fhir/r4

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

• Blackwell's Family Medicine LLC

  • Primary Care Clinic/Center
  • Tylertown, MS
  • NPI 1366003436
  Medicare reassignment Care Compare group NPD
• Dr. K's Family Medicine

  • Rural Health Clinic/Center
  • Bogalusa, LA
  • NPI 1265971147
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Forrest County General Hospital

  dba Marion General Hospital

  • General Acute Care Hospital
  • Columbia, MS
  • NPI 1427320993
  Care Compare affiliation
• Southwest Mississippi Regional Medical Center

  • General Acute Care Hospital
  • McComb, MS
  • NPI 1407805971
  Care Compare affiliation
• St. Luke Home Health Services, LLC

  • Home Health Agency
  • McComb, MS
  • NPI 1255401642
  Care Compare affiliation
• Walthall General Hospital

  • Critical Access Hospital
  • Tylertown, MS
  • NPI 1023326485
  Care Compare affiliation
• Walthall General Hospital

  dba Walthall Rural Health Clinic

  • Critical Access Hospital
  • Tylertown, MS
  • NPI 1255649604
  Care Compare affiliation

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

{
    "created_epoch": "1600905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645747200000",
    "number": "1043827900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 BALL AVE",
            "city": "TYLERTOWN",
            "state": "MS",
            "postal_code": "396672101",
            "telephone_number": "601-377-1975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "963 TAYLOR RD",
            "city": "KOKOMO",
            "state": "MS",
            "postal_code": "396434967",
            "telephone_number": "601-303-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODOM",
        "first_name": "CARLA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-24",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "904705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Camille Comfort Care Services
• Family Health Care Clinic, Inc.
• Kimberly Cathleen Martin, PMHNP
• Timothy Paul Martin, FNP-C

• Family Nurse Practitioner in Kokomo, MS
• Providers in Kokomo, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.