Odoms Eye Care, PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

677 Issued in MS

Legal business name

ODOMS EYE CARE, PLLC

Doing business as

Odoms Eye Care/Optical

Practice address

1461 Canton Mart Rd Ste a
Jackson, MS 39211-5413

Phone

(601) 977-0835

Fax

(601) 977-0689

NPI assigned

Mar 30, 2011

Last updated

Nov 23, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Dellia S McKinney, OD

Title

Owner

Phone

(601) 977-0835

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Odoms Eye Care/Optical Doing business as

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dellia Salone Evans, O.D.

  • Optometrist
  • Jackson, MS
  • NPI 1164457941
  Medicare reassignment NPD

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

{
    "created_epoch": "1301443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669161600000",
    "number": "1194014118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1461 CANTON MART RD STE A",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392115413",
            "telephone_number": "601-977-0835",
            "fax_number": "601-977-0689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1461 CANTON MART RD STE A",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392115413",
            "telephone_number": "601-977-0835",
            "fax_number": "601-977-0689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ODOMS EYE CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-30",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-23",
        "status": "A",
        "authorized_official_last_name": "MCKINNEY",
        "authorized_official_first_name": "DELLIA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-977-0835",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "677",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02735526",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Odoms Eye Care/Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tambria Odell
• Gregory S Oden, M.D.
• Rhonda Monique Odom-Funches, M.D.
• Cecil Douglas Odom, M.D.
• Odoms Eye Care Central
• Kofi Oduro-Boadu, M.D.
• Odyssey Healthcare Operating B, LP (Gentiva)
• Gloria A Ogiamien, CFNP
• Georgiana Ogletree, OT
• Lee Ogletree

• Optometrist in Jackson, MS
• Providers in Jackson, MS by specialty
• Optometrist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.