Individual provider Active NPI

Michael Odell, M.D.

  • Family Medicine Physician
  • Greeneville, TN
National Provider Identifier
1477593143
Registry record updated Jun 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
005807 Issued in TN
Practice address
438 E Vann Rd
Suite 100
Greeneville, TN 37743-7202
Phone
(423) 278-1700
Fax
(423) 278-1708
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2015

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 005807 TN Primary

Addresses

Primary practice location

438 E Vann Rd
Suite 100
Greeneville, TN 37743-7202

Mailing address

PO Box 37087
Baltimore, MD 21297-3087
Phone (828) 687-5616

Other identifiers 2

IdentifierTypeStateIssuer
31442811MedicaidTN
MD5807OtherTNSTATE LICENSES

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061204000251 TN Practitioner - Family Practice 6103858154

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Loma Linda University School of Medicine, 1964
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

PO Box
Suite 1869
Fletcher, NC 28732

Hospital & facility affiliations

  • Greeneville Community Hospital Hospital, Greeneville, TN, CCN 440050

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
005807TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Takoma Hospital & Sanitarium Training School, Inc. Past Accepting new patients

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434326400000",
    "number": "1477593143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37087",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212973087",
            "telephone_number": "828-687-5616",
            "fax_number": "828-650-8076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "438 E VANN RD",
            "address_2": "SUITE 100",
            "city": "GREENEVILLE",
            "state": "TN",
            "postal_code": "377437202",
            "telephone_number": "423-278-1700",
            "fax_number": "423-278-1708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODELL",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2015-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "005807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31442811",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSES",
            "identifier": "MD5807",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeneville, TN

Sources for this page

Verify at the official NPI Registry.