NPIMap

Individual provider Active NPI

Lynda Gayle Odom, MD

  • Family Medicine Physician
  • Denver City, TX
National Provider Identifier
1194042069
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
P6482 Issued in TX
Practice address
415 N Avenue F
West Texas Medical Center
Denver City, TX 79323-2741
Phone
(806) 592-9501
Fax
(806) 592-3052
NPI assigned
Apr 30, 2010
Last updated
Sep 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X P6482 TX Primary

Addresses

Primary practice location

415 N Avenue F
West Texas Medical Center
Denver City, TX 79323-2741

Mailing address

415 N Avenue F
Denver City, TX 79323-2741
Phone (806) 592-9501

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131007000192 TX Practitioner - Family Practice 6406080498 Reassigns benefits to 2 organizations
Practice locations: Denver City, TX

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of YoakumGroup PAC ID 3173431491, 10 clinicians

Practice addresses (Care Compare)

412 Mustang Ave
Denver City, TX 79323-5902

412 Mustang Dr
Denver City, TX 79323

412 Mustang Dr
Denver City, TX 79323-2762
Phone (806) 592-2121

603 Cowboy Way
Plains, TX 79355-9998

P O Box
Suite 1130
Denver City, TX 79323-1130

PO Box
Suite 1130
Denver City, TX 79323-1130

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
P6482TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Yoakum CurrentSince Aug 1, 2013 Accepting new patients
County of Yoakum CurrentSince Aug 1, 2013 Accepting new patients
County of Yoakum Past Accepting new patients
County of Yoakum Past Accepting new patients

Locations

412 Mustang Ave
Denver City, TX 79323
Phone (806) 592-2121

415 N Avenue F
Denver City, TX 79323
Phone (806) 592-9501

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Shinnery Oaks CommunityDenver City, TX, CCN 676259 Skilled nursing facility Adp of the SNF Nov 1, 2018

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • County of Yoakum

    dba Shinnery Oaks Community

    • Nursing Facility/Intermediate Care Facility
    • Denver City, TX
    • NPI 1275863326

    Adp of the SNF

    CMS ownership

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1272585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1194042069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 N AVENUE F",
            "city": "DENVER CITY",
            "state": "TX",
            "postal_code": "793232741",
            "telephone_number": "806-592-9501",
            "fax_number": "806-592-3052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 N AVENUE F",
            "address_2": "WEST TEXAS MEDICAL CENTER",
            "city": "DENVER CITY",
            "state": "TX",
            "postal_code": "793232741",
            "telephone_number": "806-592-9501",
            "fax_number": "806-592-3052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODOM",
        "first_name": "LYNDA",
        "middle_name": "GAYLE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-30",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "P6482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver City, TX

Sources for this page

Verify at the official NPI Registry.