Jhaelyn Alenzia Odom, N.P.

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

RN221177 Issued in GA

Practice address

2891 Lakewood Ave SW
Atlanta, GA 30315-5803

Phone

(678) 927-9996

Fax

(678) 390-9775

NPI assigned

Mar 27, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

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: 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

Interoperability endpoints

• Direct secure messaging: jhaelyn.odom.1@11755.direct.athenahealth.com

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.

• Precious L. Braswell, MD, OB/GYN, LLC

  • Obstetrics & Gynecology Physician
  • East Point, GA
  • NPI 1639255045
  Medicare reassignment NPD
• Janaso Enterprises, LLC

  • Health Service Clinic/Center
  • Sandy Springs, GA
  • NPI 1013762871
  NPD Authorized official
• Southside Medical Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Atlanta, GA
  • NPI 1235123993
  Medicare reassignment
• The Southeast Permanente Medical Group

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1245266956
  Medicare reassignment
• Lakewood Medical

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1346701216
  NPD

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

{
    "created_epoch": "1427414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1104210194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5925 SAN JUAN DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708114128",
            "telephone_number": "225-931-2594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2891 LAKEWOOD AVE SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303155803",
            "telephone_number": "678-927-9996",
            "fax_number": "678-390-9775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5925 San Juan Dr",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708114128",
            "country_code": "US",
            "telephone_number": "225-931-2594",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ODOM",
        "first_name": "JHAELYN",
        "middle_name": "ALENZIA",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-27",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "GA",
            "license": "RN221177",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "LA",
            "license": "RN133392",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95002527",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "LA",
            "license": "AP08578",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "RN95062945",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Avram Odessey, MD
• Tolulola Odetoyinbo, MD
• Alicia Odom, RN
• Andrea Odom
• Erika Odom, PHD
• Kathryn Folkner Odom, PA-C
• Sidrah Odom
• Amarachi C. Odu, PA-C
• Adanma Oduah, PA
• Anthony Adetola Odubanjo, M.D.

• Women's Health Nurse Practitioner in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Women's Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; 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.