Candice Bourgeois Odom, M.S., CCC/A

Primary specialty

AudiologistTaxonomy code 231H00000X

License

51570 Issued in TX

Practice address

18648 McKay Dr
Suite 120
Humble, TX 77338-5723

Phone

(281) 548-2626

Fax

(281) 548-1659

NPI assigned

Mar 18, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Candice Bourgeois Former name

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Qualified Audiologist

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Texas Ear, Nose and Throat Specialists, PLLCGroup PAC ID 5799770202, 123 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

95.75 of 100Reported as group

Promoting interoperability

95

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Texas Ear, Nose & Throat Specialists, PLLC

  • Otolaryngology Physician
  • McKinney, TX
  • NPI 1255314985

  Audiologist

  Medicare reassignment Care Compare group NPD
• Noble Anesthesia Partners, PLLC

  • Anesthesiology Physician
  • Irving, TX
  • NPI 1619259553
  NPD (past)

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

{
    "created_epoch": "1205798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628467200000",
    "number": "1174794192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10740 N GESSNER DR",
            "address_2": "STE 310",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770641240",
            "telephone_number": "281-897-0416",
            "fax_number": "281-890-8890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18648 MCKAY DR",
            "address_2": "SUITE 120",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773385723",
            "telephone_number": "281-548-2626",
            "fax_number": "281-548-1659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODOM",
        "first_name": "CANDICE",
        "middle_name": "BOURGEOIS",
        "credential": "M.S., CCC/A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-18",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "TX",
            "license": "51570",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "TX",
            "license": "51570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CANDICE",
            "last_name": "BOURGEOIS",
            "credential": "M.S., CCC/A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Audiologist in Humble, TX
• Providers in Humble, TX by specialty
• Audiologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.