Kreslyn Barron Odum, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

002242 Issued in GA

Practice address

420 W Cherry St
Jesup, GA 31545-1435

Phone

(478) 553-0007

Fax

(478) 552-6619

NPI assigned

Apr 6, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Kreslyn B Odum & Associates, PC

  • Optometrist
  • Jesup, GA
  • NPI 1508079179

  GA

  Medicare reassignment Authorized official
• 007 Eyes, LLC

  • Clinic/Center
  • Jesup, GA
  • NPI 1952865172
  NPD Authorized official

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1093778656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 W CHERRY ST",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315451435",
            "telephone_number": "478-553-0007",
            "fax_number": "478-552-6619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W CHERRY ST",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315451435",
            "telephone_number": "478-553-0007",
            "fax_number": "478-552-6619"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "510 Washington Ave",
            "address_purpose": "LOCATION",
            "city": "Sandersville",
            "state": "GA",
            "postal_code": "310821971",
            "country_code": "US",
            "telephone_number": "478-553-0007",
            "fax_number": "478-552-6619",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ODUM",
        "first_name": "KRESLYN",
        "middle_name": "BARRON",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-06",
        "last_updated": "2023-03-07",
        "certification_date": "2020-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "002242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11620798",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "709627117D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Matthew Orzelek, PT, DPT
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• All providers in Jesup, GA
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.