Individual provider Active NPI

Sharon Lynne Odum, CNP

  • Family Nurse Practitioner
  • Flint, MI
National Provider Identifier
1164415949
Registry record updated Feb 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704147932 Issued in MI
Practice address
2700 Robert T Longway Blvd Ste a
Flint, MI 48503-2190
Phone
(810) 659-5695
NPI assigned
Aug 26, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704147932 MI Primary

Addresses

Primary practice location

2700 Robert T Longway Blvd Ste a
Flint, MI 48503-2190

Mailing address

2700 Robert T Longway Blvd Ste a
Flint, MI 48503-2190

Other identifiers 1

IdentifierTypeStateIssuer
4872048MedicaidMI

Other names 1

  • Sharon Lynne West Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20070417000049 MI Practitioner - Nurse Practitioner 9537264783 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Coverage Services PCGroup PAC ID 3678536398, 28 clinicians

Practice addresses (Care Compare)

2700 Robert T Longway Blvd
Suite B
Flint, MI 48503-2190
Phone (810) 235-2004

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704147932MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Coverage Services PC CurrentSince Apr 18, 2018 Accepting new patients
Ahmed a. Arif MD PC CurrentSince Sep 21, 2022 Accepting new patients
HCR Manorcare Medical Services of Florida LLC Past Accepting new patients
Physician Coverage Services Past Accepting new patients

Locations

1125 S Linden Rd
Ste 210
Flint, MI 48532
Phone (810) 230-3370

2700 Robert T Longway Blvd
Flint, MI 48503
Phone (810) 235-2004

1201 Flushing Rd
Flint, MI 48504
Phone (810) 232-9100

2700 Robert T Longway Blvd
Ste A
Flint, MI 48503
Phone (810) 235-2599

2700 Robert T Longway Blvd
Ste B
Flint, MI 48503
Phone (810) 235-2004

4400 S Saginaw St
Ste 1315
Flint, MI 48507
Phone (810) 235-8861

540 Sunnyside Dr
Flushing, MI 48433
Phone (810) 487-0045

Interoperability endpoints

  • Direct secure messaging: swest8952@direct.hurleymc.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581292800000",
    "number": "1164415949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 ROBERT T LONGWAY BLVD STE A",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485032190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 ROBERT T LONGWAY BLVD STE A",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485032190",
            "telephone_number": "810-659-5695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODUM",
        "first_name": "SHARON",
        "middle_name": "LYNNE",
        "name_prefix": "Ms.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-26",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704147932",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4872048",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHARON",
            "last_name": "WEST",
            "middle_name": "LYNNE",
            "credential": "CNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.