Tammy Sue Odell, MA CCC/SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

7041 Issued in NC

Practice address

4814 Lunar Dr
Kitty Hawk, NC 27949-3937

Phone

(252) 216-5746

Fax

(252) 261-6630

NPI assigned

Mar 16, 2009

Sex

Female

Sole proprietor

No

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.

• Outer Banks Speech and Language PLLC

  • Speech-Language Pathologist
  • Kitty Hawk, NC
  • NPI 1356543250
  NPD (past) Authorized official

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 16, 2009.

{
    "created_epoch": "1237161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237161600000",
    "number": "1457592891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4814 LUNAR DR",
            "city": "KITTY HAWK",
            "state": "NC",
            "postal_code": "279493937",
            "telephone_number": "252-216-5746",
            "fax_number": "252-261-6630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4814 LUNAR DR",
            "city": "KITTY HAWK",
            "state": "NC",
            "postal_code": "279493937",
            "telephone_number": "252-216-5746",
            "fax_number": "252-261-6630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODELL",
        "first_name": "TAMMY",
        "middle_name": "SUE",
        "credential": "MA CCC/SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-16",
        "last_updated": "2009-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "7041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael B. Morgan, D.D.S.
• Jaclyn Grace Mounie, PT
• Edna Rothman Mullally, DNP, FNP-C
• Obx Optix Optometric, PLLC
• Obxmd, P.C.
• Outer Banks Physical Therapy, LLC
• Outer Banks Speech and Language PLLC
• Ashley Parham, DMD
• Justin Parker, LCAS-A, LCMHC-A
• Benjamin Perkins, PHARMD

• All providers in Kitty Hawk, NC
• Speech-Language Pathologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2009; 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.