Constance R Tambakis-Odom, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

01414 Issued in NC

Practice address

401 North Main Street
Kenansville, NC 28349

Phone

(910) 296-2738

NPI assigned

Aug 7, 2006

Last updated

Oct 19, 2007By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Southeast Anesthesiology Consultants, PLLC

  • Anesthesiology Physician
  • Charlotte, NC
  • NPI 1538124201
  Medicare reassignment NPD
• Southeast Anesthesiology Consultants, PLLC

  • Anesthesiology Physician
  • Wilmington, NC
  • NPI 1932402195
  NPD
• Comfort Anesthesia PA

  • Anesthesiology Physician
  • Kinston, NC
  • NPI 1245287606
  NPD (past)
• Openloop Healthcare Partners California PC

  • Plastic and Reconstructive Surgery Physician
  • Los Angeles, CA
  • NPI 1598418063
  NPD (past)
• Openloop Healthcare Partners PC

  • General Practice Physician
  • Des Moines, IA
  • NPI 1245820661
  NPD (past)

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192752000000",
    "number": "1093724189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SCOTT NIXON MEMORIAL DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309072464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 NORTH MAIN STREET",
            "city": "KENANSVILLE",
            "state": "NC",
            "postal_code": "28349",
            "telephone_number": "910-296-2738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAMBAKIS-ODOM",
        "first_name": "CONSTANCE",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-07",
        "last_updated": "2007-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": "01414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Curtis O. Smith, LPC, MA
• SSC Kenansville Operating Company LLC (Kenansville Health and Rehabilitation Center)
• Stevens Healthcare Agency, Inc. (Sky Rizer's Family Center)
• Kelly Stone, LCSW
• Zachary Glenn Sutton
• Jessica Myers Thomas, CLC, LCCE, CD (DONA)
• Enrique J Tomeu, MD
• Total Renal Care of North Carolina LLC (Southeastern Dialysis Center Kenansville)
• Brooke Lee Trimner, DPT
• Try Chiropractic First (Duplin County CHIROPRACTIC Center)

• Anesthesiology Physician in Kenansville, NC
• Providers in Kenansville, NC by specialty
• Anesthesiology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2007; 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.