Active NPI
Cheryl Odom
- Pharmacist
- Summerville, GA
National Provider Identifier
1205602976
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 024411
- Practice address
- 9849 Rome Blvd
Summerville, GA 30747-1585 - Phone
- (706) 857-4342
- NPI assigned
- Dec 4, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 024411 | GA | Primary |
Addresses
Primary practice location
9849 Rome Blvd
Summerville, GA 30747-1585
Mailing address
1406 Fore Winds HL
Ooltewah, TN 37363-9365
Phone (404) 242-7606
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 024411 | GA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1701648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701648000000",
"number": "1205602976",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1406 FORE WINDS HL",
"city": "OOLTEWAH",
"state": "TN",
"postal_code": "373639365",
"telephone_number": "404-242-7606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9849 ROME BLVD",
"city": "SUMMERVILLE",
"state": "GA",
"postal_code": "307471585",
"telephone_number": "706-857-4342"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ODOM",
"first_name": "CHERYL",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-12-04",
"last_updated": "2023-12-04",
"certification_date": "2023-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "024411",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Summerville, GA
- Kevin Dennis Murphy, DC
- North Georgia Healthcare Summerville
- Northwest Georgia Family Practice Center, PC
- Brittany Elaine O'Toole, FNP-BC
- Oakview Nursing & Rehabilitation Center LLC
- Shannon Owensby, RN
- P. Carl Davidson MD PC
- Stacey Hipps Page, NCC, LPC
- Mary Doster Parker, ED. S
- Magdana Philossaint, PHD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.