Leroy Odom, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

F6295 Issued in TX

Practice address

2101 Crawford St Ste 300
Houston, TX 77002-8941

Phone

(713) 658-8660

Fax

(713) 658-0205

NPI assigned

May 21, 2006

Sex

Male

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 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in TX, OH2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Physician Assistant

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 and National Provider Directory roles.

• Cleveland Clinic Mercy Hospital

  • General Acute Care Hospital
  • Canton, OH
  • NPI 1366433195
  Medicare reassignment NPD
• Kettering Independent Medical Group Inc

  • Orthopaedic Surgery Physician
  • Miamisburg, OH
  • NPI 1629387865
  Medicare reassignment NPD

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

{
    "created_epoch": "1148169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664496000000",
    "number": "1144274234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 CRAWFORD",
            "address_2": "SUITE 300",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770029014",
            "telephone_number": "713-658-8660",
            "fax_number": "713-658-0205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 CRAWFORD ST STE 300",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770028941",
            "telephone_number": "713-658-8660",
            "fax_number": "713-658-0205"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "425 W Grand Ave Ste 2002",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454054722",
            "country_code": "US",
            "telephone_number": "937-425-4144",
            "fax_number": "937-425-4146",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ODOM",
        "first_name": "LEROY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-21",
        "last_updated": "2022-09-30",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "F6295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "099388302",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lodom801735@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "425 W Grand Ave Ste 2002",
            "city": "Dayton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454054722",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "425 W Grand Ave Ste 2002",
            "city": "Dayton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454054722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bessie P. Odom
• Jessica Odom
• John Lee Odom, LCDC
• Karina Odom
• Kimberly L Odom, LPN
• Samantha Andrea Odom, SLPA
• Tanner Dwain Odom, DC
• Thomas Odonohoe, MD
• Odr Pediatric Urology Institute PLLC
• Nancy Omeogor Oduah

• Gastroenterology Physician in Houston, TX
• Providers in Houston, TX by specialty
• Gastroenterology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.