Kimberly P Odom, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME83246 Issued in FL

Practice address

613 So. Myrtle Avenue
Clearwater, FL 33756

Phone

(727) 447-6458

Fax

(727) 461-5211

NPI assigned

Jan 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.363486

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.

• Myrtle Avenue Pediatrics

  • Pediatrics Physician
  • Clearwater, FL
  • NPI 1548411432
  NPD (past)

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

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490227200000",
    "number": "1386623908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "613 SO. MYRTLE AVENUE",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "33756",
            "telephone_number": "727-442-8589",
            "fax_number": "727-461-5211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 SO. MYRTLE AVENUE",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "33756",
            "telephone_number": "727-447-6458",
            "fax_number": "727-461-5211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODOM",
        "first_name": "KIMBERLY",
        "middle_name": "P",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-12",
        "last_updated": "2017-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME83246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Patrick Obrien, PSYD
• Maria D Ocampo
• Occupational Health Centers of the Southwest P.a.
• Occupational Health Centers of the Southwest P.a.
• Madison Odell
• Catharine Odonohoe, ARNP
• John C Ofenloch, MD
• Rukeme Ogaga, MD
• Toluwalase Oluwakemi Ogunsola, CRNP
• Henry Anthony Ohleyer, MD

• Pediatrics Physician in Clearwater, FL
• Providers in Clearwater, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.