Jerry Deanie Odom Sr., D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3522 Issued in SC

Practice address

147 Pendleton St NW
Aiken, SC 29801-3859

Phone

(803) 646-4381

NPI assigned

Apr 16, 2007

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

Practice roles

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.

• Kennedy Chiropractic Center PC

  • Chiropractor
  • Moline, IL
  • NPI 1841488467
  NPD (past)
• Misi, PA

  • Specialist
  • Dallas, TX
  • NPI 1912224684
  NPD (past)
• Quad Cities Wellness and Rehabilitation Center, LTD.

  • Chiropractor
  • Moline, IL
  • NPI 1457577793
  NPD (past)

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282780800000",
    "number": "1154546240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 PENDLETON ST NW",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298013859",
            "telephone_number": "803-646-4381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 PENDLETON ST NW",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298013859",
            "telephone_number": "803-646-4381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODOM",
        "first_name": "JERRY",
        "middle_name": "DEANIE",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2010-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-010666",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "3522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northland Hearing Center, Inc.
• Novo Wellness
• Evan Null, PA-C
• Faheem B Nusrat, MD
• Ekechi Nwoga, D.C
• Shannon Odowd, LPC
• Florentina Ofoje
• Emmanuela Ginika Ogbonna, DNP, APRN, PMHNP-BC
• Ohio Valley Physicians Inc
• Robert G Olds, CRNA

• Chiropractor in Aiken, SC
• Providers in Aiken, SC by specialty
• Chiropractor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.