Lanissa Danielle Odor, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

A810645 Issued in MS

Practice address

2085 Goodman Rd W
Suite 50
Horn Lake, MS 38637-1416

Phone

(662) 253-8459

Fax

(662) 253-8678

NPI assigned

Jul 27, 2013

Last updated

Dec 30, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sandk Medical,LLCGroup PAC ID 0446578660, 2 clinicians

Fast Pace Mississippi PLLCGroup PAC ID 3678832029, 192 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/ADFEAD/Endpoint/ADFEAD

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.

• Fast Pace Mississippi, PLLC

  • Rural Health Clinic/Center
  • Ripley, MS
  • NPI 1447769559

  Family

  Medicare reassignment Care Compare group NPD
• S&K Medical,LLC

  dba Superior Health and Wellness

  • Family Medicine Physician
  • Horn Lake, MS
  • NPI 1396134151
  Medicare reassignment Care Compare group NPD
• Upperline Healthcare, PC

  • Foot & Ankle Surgery Podiatrist
  • Hoover, AL
  • NPI 1538686498

  MS

  Medicare reassignment NPD
• Fast Pace Mississippi, PLLC

  • Rural Health Clinic/Center
  • Kosciusko, MS
  • NPI 1851050579
  NPD
• Upperline Healthcare, PC

  • Foot & Ankle Surgery Podiatrist
  • Ocoee, FL
  • NPI 1326906843
  NPD
• Mid-South Ear, Nose, and Throat, P.C.

  • Otolaryngology Physician
  • Germantown, TN
  • NPI 1689780066
  NPD (past)

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

{
    "created_epoch": "1374883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451433600000",
    "number": "1083056386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2085 GOODMAN RD W",
            "address_2": "SUITE 50",
            "city": "HORN LAKE",
            "state": "MS",
            "postal_code": "386371416",
            "telephone_number": "662-253-8459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2085 GOODMAN RD W",
            "address_2": "SUITE 50",
            "city": "HORN LAKE",
            "state": "MS",
            "postal_code": "386371416",
            "telephone_number": "662-253-8459",
            "fax_number": "662-253-8678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODOR",
        "first_name": "LANISSA",
        "middle_name": "DANIELLE",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-27",
        "last_updated": "2015-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "17722",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "A810645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Newsom Healthcare, Inc
• Sandra Newsom, FNP
• Jackie D Nickson, OTD, OTR/L
• Shelley Marie Nordstrom Hammond, PHARMD
• Patrick O'Briant
• Optimal Wellness 365 LLC
• Sheila Parr, MS
• Kinyetta Phillips
• Joseph Ben Piercy, NCC, LPC, LMHC, CADC
• Virginia Grace Piercy, MS, CHES

• Family Nurse Practitioner in Horn Lake, MS
• Providers in Horn Lake, 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 Dec 30, 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.
• 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.